Provider Demographics
NPI:1407482946
Name:SOUTH FLORIDA ADVANCED SOLUTIONS LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA ADVANCED SOLUTIONS LLC
Other - Org Name:305BIOMEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:REINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-492-3736
Mailing Address - Street 1:13740 NW 19TH AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-4211
Mailing Address - Country:US
Mailing Address - Phone:305-492-3736
Mailing Address - Fax:
Practice Address - Street 1:13740 NW 19TH AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-4211
Practice Address - Country:US
Practice Address - Phone:305-492-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies