Provider Demographics
NPI:1811089360
Name:MEDIMAX, LLC
Entity type:Organization
Organization Name:MEDIMAX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-828-3161
Mailing Address - Street 1:3100 W 84TH ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4902
Mailing Address - Country:US
Mailing Address - Phone:305-828-3161
Mailing Address - Fax:305-827-7523
Practice Address - Street 1:3100 W 84TH ST
Practice Address - Street 2:UNIT 3
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4902
Practice Address - Country:US
Practice Address - Phone:305-828-3161
Practice Address - Fax:305-827-7523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies