Organization
LUCKY MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISMAIL KABOOK (OWNER)
(727) 351-7948
Entity
Organization
Contact information
Practice address
14004 ROOSEVELT BLVD STE 612, CLEARWATER, FL 33762-3819
(727) 351-7948
Mailing address
14004 ROOSEVELT BLVD STE 612, CLEARWATER, FL 33762-3819
(727) 351-7948
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/04/2018
Last updated
02/03/2018
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