Organization
DURAMED MOBILITY OF FLA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL P. CARLYLE (PRESIDENT/OWNER)
(904) 296-9339
Entity
Organization
Contact information
Practice address
8110 CYPRESS PLAZA DRIVE, SUITE 308, JAX, FL 32256-4469
(904) 296-9339
(904) 296-9338
Mailing address
8110 CYPRESS PLAZA DRIVE, SUITE 308, JACKSONVILLE, FL 32256-4469
(904) 296-9339
(904) 296-9338
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1420
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000308200
BRAIN & SPINAL MEDICAID WAIVER PROGRAM
FL
05
—
0008228-00
—
FL
01
—
1420
FL AHCA HME LICENSE
FL
Enumeration date
04/06/2006
Last updated
09/06/2012
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