| Organization Name: | SOTHSIDE MEDICAL SERVICE |
| NPI Number: | 1861437931 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IGNACIO FIGUEROA (OWNER) |
| Mailing Address: | 8199 Nw 74th Ave 8199 Medley |
| State: | FL US |
| Postal Code: | 331667401 |
| Phone Number: | 3058633077 |
| Fax Number: | 3058633079 |
| NPI Enumeration Date: | 06/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 1013260001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |