# ITO MEDICAL, LLC

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

## Provider details

- **NPI number:** 1164040598
- **Authorized official:** MR. OLIVER DAVID GARCIA (PARTNER)
- **Authorized official phone:** (610) 247-2698

## Contact information

- **Practice address:** 79 SW 12TH ST APT 1511, MIAMI, FL 33130-5203
- **Practice address phone:** (610) 247-2698
- **Mailing address:** 79 SW 12TH ST APT 1511, MIAMI, FL 33130-5203
- **Mailing address phone:** (610) 247-2698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | — |
| 302R00000X | Health Maintenance Organization | — | NULL | — |
| 305R00000X | Preferred Provider Organization | — | NULL | — |
| 305S00000X | Point of Service | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/13/2020
- **Last updated:** 07/13/2020