Provider Demographics
NPI:1336123678
Name:SURF DRUGS INC
Entity Type:Organization
Organization Name:SURF DRUGS INC
Other - Org Name:SURFMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-948-6429
Mailing Address - Street 1:2799 SW 32ND AVE
Mailing Address - Street 2:BUILDING E SUITE 14
Mailing Address - City:PEMBROKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-7700
Mailing Address - Country:US
Mailing Address - Phone:305-948-6429
Mailing Address - Fax:305-865-6255
Practice Address - Street 1:2799 SW 32ND AVE
Practice Address - Street 2:BUILDING E SUITE 14
Practice Address - City:PEMBROKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-7700
Practice Address - Country:US
Practice Address - Phone:305-948-6429
Practice Address - Fax:305-865-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1679332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103254201Medicaid
FL006797600Medicaid
FL0402210001Medicare NSC