Organization
PARK PLAZA SUPPLIES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PICHS (PRESIDENT)
(305) 220-7550
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD, SUITE 2G12, MIAMI, FL 33172-7018
(305) 220-7550
(305) 220-7499
Mailing address
175 FONTAINEBLEAU BLVD, SUITE 2G12, MIAMI, FL 33172-7018
(305) 220-7550
(305) 220-7499
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NOT REQ FOR PRV TYPE
FL
Other
Enumeration date
11/14/2006
Last updated
02/04/2008
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