Provider Demographics
NPI:1417656885
Name:FULL SERVICE MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:FULL SERVICE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-387-2817
Mailing Address - Street 1:2045 BISCAYNE BLVD STE 499
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5025
Mailing Address - Country:US
Mailing Address - Phone:786-387-2817
Mailing Address - Fax:
Practice Address - Street 1:17948 NW 59TH AVE
Practice Address - Street 2:UNIT #103
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015
Practice Address - Country:US
Practice Address - Phone:786-387-2817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies