Provider Demographics
NPI:1902836729
Name:NORLIE MEDICAL SERVICES
Entity Type:Organization
Organization Name:NORLIE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ORAZIO
Authorized Official - Middle Name:
Authorized Official - Last Name:LICCIARDELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-971-5656
Mailing Address - Street 1:12360 SW 132ND CT
Mailing Address - Street 2:113
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186
Mailing Address - Country:US
Mailing Address - Phone:305-971-5656
Mailing Address - Fax:305-971-0224
Practice Address - Street 1:12360 SW 132ND CT
Practice Address - Street 2:113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186
Practice Address - Country:US
Practice Address - Phone:305-971-5656
Practice Address - Fax:305-971-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10669332B00000X
332BP3500X
FL320442332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5078650001Medicare ID - Type Unspecified