# PEDIATRIC SUPPLIER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033157524
- **Authorized official:** MR. ROBERT JUNCO JR. (PRESIDENT)
- **Authorized official phone:** (305) 969-3484

## Contact information

- **Practice address:** 13482 SW 131ST ST, MIAMI, FL 33186-5891
- **Practice address phone:** (305) 969-3484
- **Practice address fax:** (305) 969-3482
- **Mailing address:** 13482 SW 131ST ST, MIAMI, FL 33186-5891
- **Mailing address phone:** (305) 969-3484
- **Mailing address fax:** (305) 969-3482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1312752 | FL | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 02/29/2012