Provider Demographics
NPI:1316599582
Name:TREBOL MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:TREBOL MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:ALONSO
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-333-7002
Mailing Address - Street 1:8370 W FLAGLER ST # 115K
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2094
Mailing Address - Country:US
Mailing Address - Phone:786-333-7002
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST # 115K
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2094
Practice Address - Country:US
Practice Address - Phone:786-333-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies