Provider Demographics
NPI:1760541213
Name:NORTH FLORIDA MEDICAL SALES AND RENTALS OF GAINESVILLE, INC.
Entity Type:Organization
Organization Name:NORTH FLORIDA MEDICAL SALES AND RENTALS OF GAINESVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:SID
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-331-8088
Mailing Address - Street 1:3558 NW 97TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7323
Mailing Address - Country:US
Mailing Address - Phone:352-331-8088
Mailing Address - Fax:352-331-8087
Practice Address - Street 1:3558 NW 97TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7323
Practice Address - Country:US
Practice Address - Phone:352-331-8088
Practice Address - Fax:352-331-8087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312941332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9835OtherBLUE CROSS BLUE SHIELD
FL0313050Medicaid
FL5537890001Medicare ID - Type Unspecified