Provider Demographics
NPI:1497846794
Name:PALMETTO MEDICAL EQUIPMENT & SUPPLIES INC.
Entity Type:Organization
Organization Name:PALMETTO MEDICAL EQUIPMENT & SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CIPRIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-820-3028
Mailing Address - Street 1:14226 SW 167TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1874
Mailing Address - Country:US
Mailing Address - Phone:786-346-2065
Mailing Address - Fax:305-820-3028
Practice Address - Street 1:2100 WEST 76TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5539
Practice Address - Country:US
Practice Address - Phone:305-820-3028
Practice Address - Fax:305-820-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL238013489244-6332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies