Organization
MANUEL Y PAULINO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERTO DIAZ (PRESIDENT)
(305) 202-4751
Entity
Organization
Contact information
Practice address
3501 TOWNSEND BLVD # 305, JACKSONVILLE, FL 32277-9303
(305) 202-4751
Mailing address
3501 TOWNSEND BLVD # 305, JACKSONVILLE, FL 32277-9303
(305) 202-4751
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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