Provider Demographics
NPI:1720098890
Name:FAMILY MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:FAMILY MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:ORDONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-793-5455
Mailing Address - Street 1:2740 BAYSHORE DR
Mailing Address - Street 2:UNIT-15
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-5892
Mailing Address - Country:US
Mailing Address - Phone:239-793-5455
Mailing Address - Fax:239-793-5456
Practice Address - Street 1:2740 BAYSHORE DR
Practice Address - Street 2:UNIT-15
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-5892
Practice Address - Country:US
Practice Address - Phone:239-793-5455
Practice Address - Fax:239-793-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5222800001Medicare NSC