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Organization
IMAJICA MOTTLEY MEDICAL SUPPLY
Active
Organization
IMAJICA MOTTLEY MEDICAL SUPPLY
Active
Other names
Imajica Mottley MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
IMAJICA MOTTLEY (PRESIDENT)
(813) 497-2959
Entity
Organization
Contact information
Practice address
417 SILVER BEACH RD, LAKE PARK, FL 33403-3324
(813) 497-2959
(813) 592-6728
Mailing address
417 SILVER BEACH RD, LAKE PARK, FL 33403-3324
(813) 497-2959
(813) 592-6728
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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