Provider Demographics
NPI:1942311691
Name:SAN MIGUEL MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:SAN MIGUEL MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ONEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-558-7604
Mailing Address - Street 1:2100 W 76TH ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5539
Mailing Address - Country:US
Mailing Address - Phone:305-558-7604
Mailing Address - Fax:305-558-7605
Practice Address - Street 1:2100 W 76TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5539
Practice Address - Country:US
Practice Address - Phone:305-558-7604
Practice Address - Fax:305-558-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies