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Organization

MEDIVERSE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEIAKASHEBA SCOTT (OWNER)
(407) 881-1666
Entity
Organization

Contact information

Practice address
808 W CANAL ST S, BELLE GLADE, FL 33430-2942
(407) 881-1666
Mailing address
547 HUMMINGBIRD CT, KISSIMMEE, FL 34759-4434
(407) 881-1666

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
335E00000X
Prosthetic/Orthotic Supplier

Other

Enumeration date
02/04/2026
Last updated
02/04/2026
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