Provider Demographics
NPI:1447207790
Name:MORALES MEDICAL EQUIPMENT SUPPLY, INC.
Entity Type:Organization
Organization Name:MORALES MEDICAL EQUIPMENT SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LENUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-876-1298
Mailing Address - Street 1:6555 NW 30 STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-876-1298
Mailing Address - Fax:305-876-1299
Practice Address - Street 1:6555 NW 30 STREET
Practice Address - Street 2:SUITE 207
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:305-876-1298
Practice Address - Fax:305-876-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312827332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5637780001Medicare ID - Type Unspecified