Provider Demographics
NPI:1891995908
Name:O2 RESPIRATORY MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:O2 RESPIRATORY MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:817-845-4224
Mailing Address - Street 1:500 N KIMBALL AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6683
Mailing Address - Country:US
Mailing Address - Phone:817-695-4123
Mailing Address - Fax:817-652-9394
Practice Address - Street 1:364 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5370
Practice Address - Country:US
Practice Address - Phone:407-834-7950
Practice Address - Fax:407-834-7952
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:O2 RESPIRATORY MEDICAL EQUIPMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-18
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332BP3500X
FL326421332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1221190003Medicare NSC