Provider Demographics
NPI:1467506584
Name:OCEAN CONVERSIONS & MOBILITY OF FT MYERS, INC
Entity Type:Organization
Organization Name:OCEAN CONVERSIONS & MOBILITY OF FT MYERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-942-6033
Mailing Address - Street 1:5751 ZIP DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5035
Mailing Address - Country:US
Mailing Address - Phone:239-936-6333
Mailing Address - Fax:239-936-0909
Practice Address - Street 1:5751 ZIP DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-5035
Practice Address - Country:US
Practice Address - Phone:239-936-6333
Practice Address - Fax:239-936-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1496332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4873200001Medicare NSC