Provider Demographics
NPI:1568665396
Name:ANA MEDICAL SUPPLY CORP
Entity Type:Organization
Organization Name:ANA MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTESINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-429-1522
Mailing Address - Street 1:15420 SW 136 STREET
Mailing Address - Street 2:SUITE 19
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196
Mailing Address - Country:US
Mailing Address - Phone:786-429-1522
Mailing Address - Fax:786-429-1523
Practice Address - Street 1:15420 SW 136 STREET
Practice Address - Street 2:SUITE 19
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196
Practice Address - Country:US
Practice Address - Phone:786-429-1522
Practice Address - Fax:786-429-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
FL13113410332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6535880001Medicare NSC