Provider Demographics
NPI:1700568391
Name:POINCIANA MED EQUIPMENT LLC
Entity Type:Organization
Organization Name:POINCIANA MED EQUIPMENT LLC
Other - Org Name:POINCIANA MED EQUIPMENT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAMIR
Authorized Official - Middle Name:ZOE
Authorized Official - Last Name:GARAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-338-5822
Mailing Address - Street 1:1154 CHERVIL DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-5435
Mailing Address - Country:US
Mailing Address - Phone:407-338-5822
Mailing Address - Fax:
Practice Address - Street 1:1154 CHERVIL DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-5435
Practice Address - Country:US
Practice Address - Phone:407-338-5822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies