# ICIREALSTATE

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

## Provider details

- **NPI number:** 1750207064
- **Authorized official:** ROBERT HENDERSON (OWNER)
- **Authorized official phone:** (305) 504-9829

## Contact information

- **Practice address:** 560 NE 175TH TER, NORTH MIAMI BEACH, FL 33162-1948
- **Practice address phone:** (030) 550-4982
- **Mailing address:** 560 NE 175TH TER, NORTH MIAMI BEACH, FL 33162-1948

## Taxonomy

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

## Other

- **Enumeration date:** 06/29/2026
- **Last updated:** 06/29/2026