Organization
NORTH FLORIDA MEDICAL CORP.
Active
Other names
UNION MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
SALVADOR ANTONIO PEREZ (PRESIDENT)
(386) 496-1575
Entity
Organization
Contact information
Practice address
655 E MAIN ST, LAKE BUTLER, FL 32054-1352
(386) 496-3656
Mailing address
655 E MAIN ST, LAKE BUTLER, FL 32054-1352
(386) 496-3656
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
576
FL
332BX2000X
Oxygen Equipment & Supplies (DME)
32011614
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027755000
—
FL
01
—
M1087
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/22/2007
Last updated
05/24/2012
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