| Organization Name: | FLORIDA PROFESSIONAL DME CO |
| NPI Number: | 1417006651 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SERGIO A BETANCOURT (VICE-PRESIDENT) |
| Mailing Address: | 10454 Nw 31st Ter Doral |
| State: | FL US |
| Postal Code: | 331721200 |
| Phone Number: | 3054610610 |
| Fax Number: | 3054614905 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 12/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | HME 260 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |