Provider Demographics
NPI:1528195245
Name:ALGODONES MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:ALGODONES MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PDT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-266-4514
Mailing Address - Street 1:7875 BIRD RD
Mailing Address - Street 2:#225
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3510
Mailing Address - Country:US
Mailing Address - Phone:305-266-4514
Mailing Address - Fax:305-266-4524
Practice Address - Street 1:7875 BIRD RD
Practice Address - Street 2:#225
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3510
Practice Address - Country:US
Practice Address - Phone:305-266-4514
Practice Address - Fax:305-266-4524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies