# PROLENCE MEDICAL SUPPLIES & EQUIPMENTS LLC

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

## Provider details

- **NPI number:** 1730989716
- **Authorized official:** STANLEY KEVIN ETIENNE (PRESIDENT)
- **Authorized official phone:** (718) 865-6623

## Contact information

- **Practice address:** 5233 NW 33RD AVE, FORT LAUDERDALE, FL 33309-6302
- **Practice address phone:** (954) 533-3291
- **Practice address fax:** (954) 533-4805
- **Mailing address:** 5233 NW 33RD AVE, FORT LAUDERDALE, FL 33309-6302
- **Mailing address phone:** (954) 533-3291
- **Mailing address fax:** (954) 533-4805

## Taxonomy

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

## Other

- **Enumeration date:** 03/18/2025
- **Last updated:** 03/18/2025