Organization
GOODYEAR MEDICAL SUPPLY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE L HERNANDEZ (PRESIDENT)
(305) 884-0868
Entity
Organization
Contact information
Practice address
272 W 21ST ST, HIALEAH, FL 33010-2517
(305) 884-0868
(305) 884-0869
Mailing address
272 W 21ST ST, HIALEAH, FL 33010-2517
(305) 884-0868
(305) 884-0869
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Enumeration date
01/31/2007
Last updated
02/04/2008
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