Organization
BONITA SPRINGS SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYEDA MAMOONA OMER MD (CEO)
(408) 679-0011
Entity
Organization
Contact information
Practice address
8545 MONTEREY ST STE C, GILROY, CA 95020-4273
(408) 679-0011
Mailing address
8545 MONTEREY ST STE C, GILROY, CA 95020-4273
(408) 679-0011
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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