Provider Demographics
NPI:1598847386
Name:INFUSION TECHNOLOGIES INC
Entity Type:Organization
Organization Name:INFUSION TECHNOLOGIES INC
Other - Org Name:INFUSION TECHNOLOGIES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTOMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-9335
Mailing Address - Street 1:820 NE 126TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4906
Mailing Address - Country:US
Mailing Address - Phone:305-887-9335
Mailing Address - Fax:305-883-8869
Practice Address - Street 1:5803 BRECKENRIDGE PKWY
Practice Address - Street 2:STE.A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4247
Practice Address - Country:US
Practice Address - Phone:813-514-1676
Practice Address - Fax:813-514-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X, 3336S0011X
FLPH182573336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1007877OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PA4012158610001Medicaid
KY54010996Medicaid
OH2610795Medicaid
FL026732500Medicaid
PA4012158610001Medicaid