Provider Demographics
NPI:1659568087
Name:SS MEDICAL SERVICES CORP
Entity Type:Organization
Organization Name:SS MEDICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-245-7710
Mailing Address - Street 1:311 NE 8TH ST
Mailing Address - Street 2:STE 108
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4738
Mailing Address - Country:US
Mailing Address - Phone:305-245-7710
Mailing Address - Fax:305-245-7789
Practice Address - Street 1:311 NE 8TH ST
Practice Address - Street 2:STE 108
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4738
Practice Address - Country:US
Practice Address - Phone:305-245-7710
Practice Address - Fax:305-245-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH229333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1029936OtherNCPDP
FLFS0684349OtherDEA
FL6012190001Medicare NSC