Provider Demographics
NPI:1811189111
Name:IVANA MEDICAL EQUIPMENT & SUPPLIES CORP
Entity type:Organization
Organization Name:IVANA MEDICAL EQUIPMENT & SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMONA DE FONTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-458-1320
Mailing Address - Street 1:1008 NE 7TH TER
Mailing Address - Street 2:UNIT C
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-3100
Mailing Address - Country:US
Mailing Address - Phone:239-458-1320
Mailing Address - Fax:239-573-1340
Practice Address - Street 1:1008 NE 7TH TER
Practice Address - Street 2:UNIT C
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-3100
Practice Address - Country:US
Practice Address - Phone:239-458-1320
Practice Address - Fax:239-573-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLYO BE ANNOUNCED332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherPENDING MEDICARE NSC #
FLPENDINGOtherPENDING MEDICARE NSC #