Provider Demographics
NPI:1568114809
Name:BLUE KITE MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:BLUE KITE MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-323-9115
Mailing Address - Street 1:13200 SW 128TH ST STE E1B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5881
Mailing Address - Country:US
Mailing Address - Phone:305-323-9115
Mailing Address - Fax:
Practice Address - Street 1:13200 SW 128TH ST STE B1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5826
Practice Address - Country:US
Practice Address - Phone:305-323-9115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies