Organization
FLORIDA PROFESSIONAL DME CO
Active
Organization
FLORIDA PROFESSIONAL DME CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGIO A BETANCOURT (VICE-PRESIDENT)
(305) 461-0610
Entity
Organization
Contact information
Practice address
10454 NW 31ST TER, DORAL, FL 33172-1200
(305) 461-0610
(305) 461-4905
Mailing address
10454 NW 31ST TER, DORAL, FL 33172-1200
(305) 461-0610
(305) 461-4905
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HME 260
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R8410
BCBS PROV NUMBER
FL
Enumeration date
01/09/2007
Last updated
06/20/2018
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