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Organization

EXCEL RESPIRATORY SOLUTIONS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK RANDAL HAGMAN (PRESIDENT)
(863) 698-3111
Entity
Organization

Contact information

Practice address
334 3RD ST NW, WINTER HAVEN, FL 33881-4002
(863) 299-2500
(863) 299-2511
Mailing address
334 3RD ST NW, WINTER HAVEN, FL 33881-4002
(863) 299-2500
(863) 299-2511

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
3204482
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1312801
FL MEDICAL EQUIPMENT LIC
FL
01
24002
WINTER HAVEN OCCP LIC
FL
01
3204482
FL MEDICAL OXYGEN PERMIT
FL
01
99700007892
POLK COUNTY OCCP LIC
FL
01
R9798
BLUE CROSSBLUE SHIELD
FL
Enumeration date
01/10/2007
Last updated
03/05/2008
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