Provider Demographics
NPI:1568513661
Name:MEDICAL EQUIPMENT SOLUTIONS OF SOUTHEAST FLORIDA, LLC
Entity Type:Organization
Organization Name:MEDICAL EQUIPMENT SOLUTIONS OF SOUTHEAST FLORIDA, LLC
Other - Org Name:MEDICAL EQUIPMENT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:VANCE
Authorized Official - Last Name:KARLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-580-0262
Mailing Address - Street 1:311 JOHNNIE DODDS BLVD
Mailing Address - Street 2:SUITE 161
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2976
Mailing Address - Country:US
Mailing Address - Phone:772-236-5813
Mailing Address - Fax:772-236-5815
Practice Address - Street 1:311 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE 161
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2976
Practice Address - Country:US
Practice Address - Phone:772-236-5813
Practice Address - Fax:772-236-5815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5057020001OtherPTAN
FL1568513661OtherNPI
FL5057020001OtherPTAN