# CLEVELAND MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1336758945
- **Authorized official:** JOSE LUIS HERNANDEZ (PRESIDENT)
- **Authorized official phone:** (239) 984-2814

## Contact information

- **Practice address:** 1306 SE 46TH LN STE 1B, CAPE CORAL, FL 33904-8647
- **Practice address phone:** (239) 984-2814
- **Practice address fax:** (239) 984-2212
- **Mailing address:** 1306 SE 46TH LN STE 1B, CAPE CORAL, FL 33904-8647
- **Mailing address phone:** (239) 984-2814
- **Mailing address fax:** (239) 984-2212

## Taxonomy

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

## Other

- **Enumeration date:** 07/29/2020
- **Last updated:** 10/29/2020