Organization
PET RHINO INC
Active
Other names
CVI MEDICAL OF FLORIDA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WILLIAM KELLEY (PRESIDENT)
(813) 908-5302
Entity
Organization
Contact information
Practice address
5008 W LINEBAUGH AVE, STE 9, TAMPA, FL 33624-5095
(813) 908-5302
(813) 908-7013
Mailing address
5008 W LINEBAUGH AVE, STE 9, TAMPA, FL 33624-5095
(813) 908-5302
(813) 908-7013
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1313414
FL
332BC3200X
Customized Equipment (DME)
Primary
1313414
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032609700
—
FL
01
—
R001U
BCBSFL
FL
Enumeration date
12/28/2010
Last updated
06/09/2011
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