Organization Name: | TRACERALLEN MEDICAL |
NPI Number: | 1447693783 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICK TOMASSI (MANAGER/ OWNER) |
Mailing Address: | 4226 Isle Vista Ave Belle Isle |
State: | FL US |
Postal Code: | 328122224 |
Phone Number: | 4074924597 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2013 |
NPI Last Update Date: | 04/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |