Provider Demographics
NPI:1730123092
Name:P MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:P MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-718-3295
Mailing Address - Street 1:2500 NW 79TH AVE
Mailing Address - Street 2:STE 213
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1071
Mailing Address - Country:US
Mailing Address - Phone:305-718-3295
Mailing Address - Fax:305-718-3294
Practice Address - Street 1:2500 NW 79TH AVE
Practice Address - Street 2:STE 213
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1071
Practice Address - Country:US
Practice Address - Phone:305-718-3295
Practice Address - Fax:305-718-3294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
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
FL=========OtherTAX ID