Provider Demographics
NPI:1821152158
Name:MANNY'S MEDICAL SUPPLIES,INC.
Entity Type:Organization
Organization Name:MANNY'S MEDICAL SUPPLIES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-344-1349
Mailing Address - Street 1:2262 NW 94TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2333
Mailing Address - Country:US
Mailing Address - Phone:305-436-1144
Mailing Address - Fax:305-436-1188
Practice Address - Street 1:2262 NW 94TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2333
Practice Address - Country:US
Practice Address - Phone:305-436-1144
Practice Address - Fax:305-436-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies