Provider Demographics
NPI:1790758936
Name:DURA MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:DURA MEDICAL EQUIPMENT, INC.
Other - Org Name:BAYSHORE DURA MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDIA
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:305-821-1202
Mailing Address - Street 1:6780 SW 81ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7710
Mailing Address - Country:US
Mailing Address - Phone:305-821-1202
Mailing Address - Fax:305-821-1297
Practice Address - Street 1:6780 SW 81ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7710
Practice Address - Country:US
Practice Address - Phone:305-821-1202
Practice Address - Fax:305-821-1297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL950369200Medicaid
FL0366080001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER