# SPORTS MED INNOVATIONS INC

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

## Provider details

- **NPI number:** 1134320914
- **Authorized official:** JOSE GABRIEL MACIAS (PRESIDENT)
- **Authorized official phone:** (305) 234-7788

## Contact information

- **Practice address:** 717 PONCE DE LEON BLVD, SUITE 221, CORAL GABLES, FL 33134-2060
- **Practice address phone:** (305) 234-7788
- **Practice address fax:** (305) 969-9274
- **Mailing address:** 717 PONCE DE LEON BLVD, STE 221, CORAL GABLES, FL 33134-2060
- **Mailing address phone:** (305) 234-7788
- **Mailing address fax:** (305) 969-9274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 6047450001 | FL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/30/2007
- **Last updated:** 04/14/2009