Provider Demographics
NPI:1659434116
Name:ACEVEDO'S GLOSERVICE CORP
Entity Type:Organization
Organization Name:ACEVEDO'S GLOSERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-882-8855
Mailing Address - Street 1:63 W 21ST ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2666
Mailing Address - Country:US
Mailing Address - Phone:305-882-8855
Mailing Address - Fax:305-883-0680
Practice Address - Street 1:63 W 21ST ST
Practice Address - Street 2:SUITE 4
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2666
Practice Address - Country:US
Practice Address - Phone:305-882-8855
Practice Address - Fax:305-883-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies