Provider Demographics
NPI:1588679393
Name:I.R. MEDICAL EQUIPMENT, CORP.
Entity Type:Organization
Organization Name:I.R. MEDICAL EQUIPMENT, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-7510
Mailing Address - Street 1:2367 W 80TH ST
Mailing Address - Street 2:BAY #4
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-7300
Mailing Address - Country:US
Mailing Address - Phone:305-821-7510
Mailing Address - Fax:305-821-9968
Practice Address - Street 1:2367 W 80TH ST
Practice Address - Street 2:BAY #4
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-7300
Practice Address - Country:US
Practice Address - Phone:305-821-7510
Practice Address - Fax:305-821-9968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312072332B00000X
332BP3500X
FL3203669332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5097250001Medicare ID - Type UnspecifiedPROVIDER #