Organization
FIRST RESPONSE MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA GONZALEZ (OFFICE MANAGER)
(305) 412-9393
Entity
Organization
Contact information
Practice address
10240 SW 56TH ST, STE 112C, MIAMI, FL 33165-7070
(305) 412-9393
(305) 412-9394
Mailing address
10240 SW 56TH ST, STE 112C, MIAMI, FL 33165-7070
(305) 412-9393
(305) 412-9394
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
01875
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211769
AMERIGROUP PROVIDER
FL
01
—
R8891
BLUE CROSS PROVIDER
FL
Enumeration date
05/23/2005
Last updated
08/22/2020
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