Organization
AMANDA MEDICAL
Active
Other names
Active Mobility Innovations
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUBEN EUGENE JONES M.S., ATP (PRESIDENT)
(727) 535-6100
Entity
Organization
Contact information
Practice address
3720 TAMPA RD, PALM HARBOR, FL 34684-3621
(727) 535-6100
(727) 535-6466
Mailing address
3720 TAMPA RD, PALM HARBOR, FL 34684-3621
(727) 535-6100
(727) 535-6466
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1039
FL
332BC3200X
Customized Equipment (DME)
Primary
1039
FL
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
1039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026266800
—
FL
Enumeration date
06/16/2005
Last updated
04/28/2022
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