Organization
LIFESTYLE MED SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NESTOR RODRIGUEZ (AUTHORIZED OFFICIAL)
(305) 898-9756
Entity
Organization
Contact information
Practice address
1275 W 49TH PL STE 423, HIALEAH, FL 33012-3139
(786) 334-6187
Mailing address
1275 W 49TH PL STE 423, HIALEAH, FL 33012-3139
(786) 334-6187
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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