Provider Demographics
NPI:1922344746
Name:BIOFIT MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:BIOFIT MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOULTON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-270-8383
Mailing Address - Street 1:9415 SUNSET DR
Mailing Address - Street 2:143
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5427
Mailing Address - Country:US
Mailing Address - Phone:305-270-8383
Mailing Address - Fax:
Practice Address - Street 1:9415 SUNSET DR
Practice Address - Street 2:143
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5427
Practice Address - Country:US
Practice Address - Phone:305-270-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies