# TAMARA MEDICAL SUPPLY, CORP.

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

## Provider details

- **NPI number:** 1134156284
- **Authorized official:** TAMARA VIQUILLON (PRESIDENT)
- **Authorized official phone:** (786) 301-1571

## Contact information

- **Practice address:** 12350 SW 132ND CT, SUITE 203, MIAMI, FL 33186-6456
- **Practice address phone:** (786) 301-1571
- **Mailing address:** 12350 SW 132ND CT, SUITE 203, MIAMI, FL 33186-6456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 648 | FL | Yes |

## Other

- **Enumeration date:** 06/26/2006
- **Last updated:** 08/22/2020