Provider Demographics
NPI:1851365118
Name:DEL RISCO MEDICAL SERVICES CORP
Entity Type:Organization
Organization Name:DEL RISCO MEDICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELRISCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-823-7500
Mailing Address - Street 1:9807 NW 80TH AVE
Mailing Address - Street 2:BAY NO 11C
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-823-7500
Mailing Address - Fax:305-823-0157
Practice Address - Street 1:9807 NW 80TH AVE
Practice Address - Street 2:BAY NO 11C
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-823-7500
Practice Address - Fax:305-823-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312819AHCA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies