Provider Demographics
NPI:1780749085
Name:U.S. MEDICAL AND SURGICAL SUPPLY CORP
Entity type:Organization
Organization Name:U.S. MEDICAL AND SURGICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-442-0069
Mailing Address - Street 1:6135 NW 167 STREET
Mailing Address - Street 2:E13
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33015
Mailing Address - Country:US
Mailing Address - Phone:305-442-0069
Mailing Address - Fax:
Practice Address - Street 1:6135 NW 167TH ST
Practice Address - Street 2:E13
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4338
Practice Address - Country:US
Practice Address - Phone:305-442-0069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies