Provider Demographics
NPI:1447736699
Name:MED SONIC LLC
Entity Type:Organization
Organization Name:MED SONIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-491-8601
Mailing Address - Street 1:1001 W CYPRESS CREEK RD STE 111
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1947
Mailing Address - Country:US
Mailing Address - Phone:954-491-8601
Mailing Address - Fax:
Practice Address - Street 1:1001 W CYPRESS CREEK RD STE 111
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1947
Practice Address - Country:US
Practice Address - Phone:954-491-8601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies