Provider Demographics
NPI:1720193667
Name:ROYAL MEDICAL SERVICES CORP
Entity Type:Organization
Organization Name:ROYAL MEDICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:LAZARO
Authorized Official - Last Name:CARBONELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-251-9321
Mailing Address - Street 1:12461 SW 130TH ST
Mailing Address - Street 2:A9
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6235
Mailing Address - Country:US
Mailing Address - Phone:305-251-9321
Mailing Address - Fax:305-251-9273
Practice Address - Street 1:12461 SW 130TH ST
Practice Address - Street 2:A9
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6235
Practice Address - Country:US
Practice Address - Phone:305-251-9321
Practice Address - Fax:305-251-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5768360001Medicare NSC