Provider Demographics
NPI:1205326444
Name:MDSS SERVICES LLC
Entity type:Organization
Organization Name:MDSS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL SOCORRO
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-218-3589
Mailing Address - Street 1:2593 COURTLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2543
Mailing Address - Country:US
Mailing Address - Phone:386-218-3589
Mailing Address - Fax:386-218-3769
Practice Address - Street 1:2593 COURTLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-2543
Practice Address - Country:US
Practice Address - Phone:386-218-3589
Practice Address - Fax:386-218-3769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023789300Medicaid