# POINCIANA MEDICAL SUPPLIES LLC

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

## Provider details

- **NPI number:** 1083351555
- **Authorized official:** MR. HECTOR L RODRIGUEZ BA (DIRECTOR)
- **Authorized official phone:** (407) 350-4138

## Contact information

- **Practice address:** 105 E MONUMENT AVE, KISSIMMEE, FL 34741-5761
- **Practice address phone:** (407) 350-4138
- **Practice address fax:** (321) 250-4309
- **Mailing address:** PO BOX 452848, KISSIMMEE, FL 34745-2848
- **Mailing address phone:** (407) 350-4138

## Taxonomy

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

## Other

- **Enumeration date:** 05/17/2022
- **Last updated:** 01/11/2023