Provider Demographics
NPI:1720185325
Name:SCULAPIUS MEDICAL SERVICES
Entity Type:Organization
Organization Name:SCULAPIUS MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:COSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-557-9229
Mailing Address - Street 1:10550 NW 77 CT
Mailing Address - Street 2:STE 310
Mailing Address - City:HIALEAH GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-557-9229
Mailing Address - Fax:305-557-9233
Practice Address - Street 1:10550 NW 77 CT
Practice Address - Street 2:STE 310
Practice Address - City:HIALEAH GARDEN
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-557-9229
Practice Address - Fax:305-557-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5700210001Medicare ID - Type Unspecified