Organization
IMAJICA MOTTLEY MEDICAL SUPPLY
Active
Other names
Imajica Mottley MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
IMAJICA MOTTLEY (PRESIDENT)
(813) 497-2959
Entity
Organization
Contact information
Practice address
417 SILVER BEACH RD, LAKE PARK, FL 33403-3324
(813) 497-2959
(813) 592-6728
Mailing address
417 SILVER BEACH RD, LAKE PARK, FL 33403-3324
(813) 497-2959
(813) 592-6728
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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