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Organization

DIABETES SELF MANAGEMENT SUPPLIES

Active
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Organization

DIABETES SELF MANAGEMENT SUPPLIES

Active
Other names
Diabetes & Nutrition Centers
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY FONDA (PRESIDENT)
(561) 515-0848
Entity
Organization

Contact information

Practice address
12230 W FOREST HILL BLVD, SUITE 178, WELLINGTON, FL 33414-5700
(561) 515-0848
(561) 333-2640
Mailing address
12230 W FOREST HILL BLVD, SUITE 178, WELLINGTON, FL 33414-5700
(561) 515-0848
(561) 333-2640

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL

Other

Enumeration date
09/29/2006
Last updated
02/10/2009
About Stedi
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