Organization
GEORGIA MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOLBERTO PELAEZ (PRESIDENT)
(786) 768-1499
Entity
Organization
Contact information
Practice address
3450 W 84TH ST, 102-C, HIALEAH, FL 33018-4924
(786) 768-1499
(305) 477-6518
Mailing address
3450 W 84TH ST, 102-C, HIALEAH, FL 33018-4924
(786) 768-1499
(305) 477-6518
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2057698887
EIN
FL
Enumeration date
11/15/2006
Last updated
08/22/2020
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