Organization
PRIME TIME MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK R. MIKLOS (PRESIDENT)
(727) 548-8386
Entity
Organization
Contact information
Practice address
7201 BRYAN DAIRY RD, LARGO, FL 33777-1505
(727) 548-8386
(727) 548-7985
Mailing address
7201 BRYAN DAIRY RD, LARGO, FL 33777-1505
(727) 548-8386
(727) 548-7985
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002348200
—
FL
Enumeration date
07/16/2008
Last updated
12/21/2010
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