Organization
ELITE DIABETIC HEALTHCARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE GIBBS (AUTHORIZED OFFICIAL)
(601) 513-4956
Entity
Organization
Contact information
Practice address
10675 SW 190TH ST STE 1208, CUTLER BAY, FL 33157-7712
(601) 513-4956
Mailing address
10675 SW 190TH ST STE 1208, CUTLER BAY, FL 33157-7712
(601) 513-4956
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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