Provider Demographics
NPI:1659368355
Name:INDA MEDICAL SERVICES
Entity Type:Organization
Organization Name:INDA MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:INDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-819-3366
Mailing Address - Street 1:2135 W 60TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2602
Mailing Address - Country:US
Mailing Address - Phone:305-819-3366
Mailing Address - Fax:305-819-9931
Practice Address - Street 1:2135 W 60TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2602
Practice Address - Country:US
Practice Address - Phone:305-819-3366
Practice Address - Fax:305-819-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL686332B00000X
FL3201987332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0978650001Medicare ID - Type UnspecifiedPROVIDER