Provider Demographics
NPI:1942254933
Name:JEO MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:JEO MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-477-9295
Mailing Address - Street 1:8009 NW 36TH ST
Mailing Address - Street 2:SUITE 233
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6638
Mailing Address - Country:US
Mailing Address - Phone:305-477-9295
Mailing Address - Fax:
Practice Address - Street 1:8009 NW 36TH ST
Practice Address - Street 2:SUITE 233
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6638
Practice Address - Country:US
Practice Address - Phone:305-477-9295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312826332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5618620001Medicare ID - Type Unspecified