Provider Demographics
NPI:1386858579
Name:LJA MEDICAL EQUIOPMENT CORP
Entity Type:Organization
Organization Name:LJA MEDICAL EQUIOPMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-987-3992
Mailing Address - Street 1:3600 S STATE ROAD 7
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5200
Mailing Address - Country:US
Mailing Address - Phone:954-987-3992
Mailing Address - Fax:954-987-3992
Practice Address - Street 1:3600 S STATE ROAD 7
Practice Address - Street 2:SUITE 340
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5200
Practice Address - Country:US
Practice Address - Phone:954-987-3992
Practice Address - Fax:954-987-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5558760001Medicare NSC