Provider Demographics
NPI:1396625109
Name:CAPITAL CARE MEDICAL SUPPLY
Entity type:Organization
Organization Name:CAPITAL CARE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEZEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-418-6630
Mailing Address - Street 1:1926 HOLLYWOOD BLVD STE 216
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4538
Mailing Address - Country:US
Mailing Address - Phone:954-408-8323
Mailing Address - Fax:
Practice Address - Street 1:1926 HOLLYWOOD BLVD STE 216
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4538
Practice Address - Country:US
Practice Address - Phone:954-408-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies