Provider Demographics
NPI:1932691912
Name:A&B EXCELLENT MEDICAL SERVICE CORP
Entity Type:Organization
Organization Name:A&B EXCELLENT MEDICAL SERVICE CORP
Other - Org Name:A&B EXCELLENT MEDICAL SERVICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-591-9861
Mailing Address - Street 1:7660 NW 186TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2925
Mailing Address - Country:US
Mailing Address - Phone:407-591-9861
Mailing Address - Fax:
Practice Address - Street 1:7660 NW 186TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2925
Practice Address - Country:US
Practice Address - Phone:407-591-9861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies