# FLORIDA HOME MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Colonial Medical Supplies
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114125143
- **Authorized official:** WENDY RUSSALESI (CCO)
- **Authorized official phone:** (484) 246-9499

## Contact information

- **Practice address:** 1113 N CENTRAL AVE, KISSIMMEE, FL 34741-4405
- **Practice address phone:** (407) 849-6455
- **Practice address fax:** (407) 849-6458
- **Mailing address:** 555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 1313277 | FL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 07/11/2007
- **Last updated:** 05/27/2026