Provider Demographics
NPI:1356488894
Name:UNIMED SUPPLIES, CORP.
Entity Type:Organization
Organization Name:UNIMED SUPPLIES, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERTO JAVIER
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARIAS CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-406-3455
Mailing Address - Street 1:5209 NW 74TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4800
Mailing Address - Country:US
Mailing Address - Phone:305-406-3455
Mailing Address - Fax:305-406-3469
Practice Address - Street 1:5209 NW 74TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4800
Practice Address - Country:US
Practice Address - Phone:305-406-3455
Practice Address - Fax:305-406-3469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING #332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5941640001Medicare NSC