# ELEGANCE MEDICAL SUPPLY CORP.

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

## Provider details

- **NPI number:** 1487306155
- **Authorized official:** WALTER PRADO (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (754) 336-1232

## Contact information

- **Practice address:** 8358 W OAKLAND PARK BLVD STE 203D, SUNRISE, FL 33351-7341
- **Practice address phone:** (754) 336-1232
- **Mailing address:** 8358 W OAKLAND PARK BLVD STE 203D, SUNRISE, FL 33351-7341
- **Mailing address phone:** (754) 336-1232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 01/24/2022
- **Last updated:** 06/16/2022