Organization
BAYSHORE DURAMEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MENDIA (PRESIDENT)
(305) 821-1202
Entity
Organization
Contact information
Practice address
7835 NW 148TH ST, MIAMI LAKES, FL 33016-1554
(305) 821-1202
(305) 821-1297
Mailing address
7835 NW 148TH ST, MIAMI LAKES, FL 33016-1554
(305) 821-1202
(305) 821-1297
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
950369200
—
FL
Enumeration date
10/18/2013
Last updated
10/18/2013
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