# MEDIVANCE SUPPLY CORP

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

## Provider details

- **NPI number:** 1366372138
- **Authorized official:** ADEEM UL HASSAN KHAN (PRESIDENT)
- **Authorized official phone:** (945) 403-2756

## Contact information

- **Practice address:** 10469 DOWN LAKEVIEW CIR, WINDERMERE, FL 34786-7910
- **Practice address phone:** (945) 403-2756
- **Practice address fax:** (945) 403-2756
- **Mailing address:** 10469 DOWN LAKEVIEW CIR, WINDERMERE, FL 34786-7910
- **Mailing address phone:** (945) 403-2756
- **Mailing address fax:** (945) 403-2756

## Taxonomy

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

## Other

- **Enumeration date:** 05/21/2026
- **Last updated:** 05/21/2026