# ICON MED TECH CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ICON MED TECH CORPORATION
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255511499
- **Authorized official:** GUSTAVO ADOLFO GARCIA (PRESIDENT)
- **Authorized official phone:** (305) 222-9164

## Contact information

- **Practice address:** 175 FONTAINEBLEAU BLVD, 2 K 6, MIAMI, FL 33172
- **Practice address phone:** (305) 222-9164
- **Mailing address:** 175 FONTAINEBLEAU BLVD, 2 K 6, MIAMI, FL 33172-7018
- **Mailing address phone:** (305) 222-9164

## Taxonomy

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

## Other

- **Enumeration date:** 11/05/2007
- **Last updated:** 04/16/2008