Organization
FLORIDA HOME MEDICAL SUPPLY LLC
Active
Other names
Colonial Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSALESI (CCO)
(484) 246-9499
Entity
Organization
Contact information
Practice address
1113 N CENTRAL AVE, KISSIMMEE, FL 34741-4405
(407) 849-6455
(407) 849-6458
Mailing address
555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1313277
FL
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001517300
—
FL
01
—
1313277
HOME MEDICAL EQUIPMENT SUPPLIER
FL
01
—
327174
MEDICAL OXYGEN RETAIL SUPPLIER
FL
Enumeration date
07/11/2007
Last updated
10/14/2025
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