Provider Demographics
NPI:1720174337
Name:MG HEALTH EQUIPMENT SERVICE, INC.
Entity Type:Organization
Organization Name:MG HEALTH EQUIPMENT SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-884-2010
Mailing Address - Street 1:6955 NW 77TH AVENUE
Mailing Address - Street 2:SUITE 408-D
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2844
Mailing Address - Country:US
Mailing Address - Phone:305-884-2010
Mailing Address - Fax:305-805-3552
Practice Address - Street 1:6955 NW 77TH AVENUE
Practice Address - Street 2:SUITE 408-D
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2844
Practice Address - Country:US
Practice Address - Phone:305-884-2010
Practice Address - Fax:305-805-3552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLICENSE#:73332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL952067800Medicaid
FL952067800Medicaid