Provider Demographics
NPI:1396841185
Name:CREATIVE MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:CREATIVE MEDICAL SERVICES, INC
Other - Org Name:CMSINC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-630-1716
Mailing Address - Street 1:8010 W. 23RD AVE STE #1
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5561
Mailing Address - Country:US
Mailing Address - Phone:305-820-0650
Mailing Address - Fax:305-362-1077
Practice Address - Street 1:8010 W. 23RD AVE STE #1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-820-0650
Practice Address - Fax:305-362-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1314529332B00000X
FL332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL950891100Medicaid
0562360001Medicare NSC
FL0562360001Medicare NSC