Provider Demographics
NPI:1811043953
Name:BROWARD DADE HOME MEDICAL EQUIP. INC.
Entity Type:Organization
Organization Name:BROWARD DADE HOME MEDICAL EQUIP. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-708-0875
Mailing Address - Street 1:2900 W SAMPLE RD
Mailing Address - Street 2:STORE 102 BAY 74
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3024
Mailing Address - Country:US
Mailing Address - Phone:954-974-9768
Mailing Address - Fax:954-974-9769
Practice Address - Street 1:2900 W SAMPLE RD
Practice Address - Street 2:STORE 102 BAY 74
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33073-3024
Practice Address - Country:US
Practice Address - Phone:954-974-9768
Practice Address - Fax:954-974-9769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1234110001Medicare ID - Type Unspecified