Provider Demographics
NPI:1851013007
Name:UNIVERSAL MARINE MEDICAL SUPPLY INTERNATIONAL, LLC
Entity Type:Organization
Organization Name:UNIVERSAL MARINE MEDICAL SUPPLY INTERNATIONAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROCCO
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:CDR, MS
Authorized Official - Phone:617-833-5017
Mailing Address - Street 1:1935 NW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2607
Mailing Address - Country:US
Mailing Address - Phone:786-822-6565
Mailing Address - Fax:
Practice Address - Street 1:1935 NW 87TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2607
Practice Address - Country:US
Practice Address - Phone:786-822-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0000000000OtherN/A