Organization
EEXECUTIVE MEDICAL SUPPLY, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE HERNANDEZ GUEVARA (PRESIDENT)
(305) 512-6090
Entity
Organization
Contact information
Practice address
1790 W 49TH ST, STE 305-9, HIALEAH, FL 33012-2992
(305) 512-6090
(305) 512-6091
Mailing address
1790 W 49TH ST, STE 305-9, HIALEAH, FL 33012-2992
(305) 512-6090
(305) 512-6091
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/18/2007
Last updated
05/02/2008
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