SOUTH FLORIDA MEDICAL STORE INC (NPI# 1710279013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710279013 |
| Entity Type | Organization |
| Organization Name | SOUTH FLORIDA MEDICAL STORE INC |
| Practice Address |
4201 Westgate Ave B-14 West Palm Beach FL 33409-4719 |
| Mailing Address |
4201 Westgate Ave Suite B-14 West Palm Beach FL 33409-4719 |
| Practice Telephone | 5618557377 |
| Practice Fax Number | 5618557378 |
| Mailing Telephone | 5618557377 |
| Mailing Fax Number | 5618557378 |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2012-04-24 |
| Authorized Official Name | MR. TIMOTHY V LEWIS (PRESIDENT) |
| Authorized Official Telephone | 5618557377 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| N | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
4201 WESTGATE AVE B-14 |
| City | WEST PALM BEACH |
| State | FL |
| Zip Code | 33409-4719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928000 | Gerard Joseph Valerius Jr. | Behavior Technician | 1818 S. Australian Ave, Suite 420, West Palm Beach, FL 33409 | 2020-10-05 |
| 1295342277 | Stela Karkatselos | Nurse Practitioner | 2700 Palm Beach Lakes Blvd., West Palm Beach, FL 33409 | 2020-09-24 |
| 1831703974 | Daylin Gonzalez | Behavior Technician | 1818 S.australian Ave, Suite 420, West Palm Beach, FL 33409 | 2020-09-05 |
| 1518582436 | All-most Family, Inc | In Home Supportive Care | 4047 Okeechobee Blvd., Suite 110, West Palm Beach, FL 33409 | 2020-06-16 |
| 1750911285 | Denisse Ramirez | Technician, Other | 1818 S. Australian Ave, Suite 420, West Palm Beach, FL 33409 | 2020-01-23 |
| 1558915009 | Hess Massage and Fitness LLC. | Massage Therapist | 2090 Palm Beach Lakes Blvd #900, West Palm Beach, FL 33409 | 2019-08-01 |
| 1184195638 | Tyrone Woods | Developmental Therapist | 4287 Lake Lucerne Circle, West Palm Beach, FL 33409 | 2018-12-10 |
| 1700352119 | Julio Cesar Lugo Sr. | Counselor | 4100 Bear Lakes Ct. Building 14, Apt. #108, West Palm Beach, FL 33409 | 2018-10-23 |
| 1073009353 | Kaitlyn Rose Green | Physician Assistant | 560 Village Blvd Suite #150, West Palm Beach, FL 33409 | 2018-07-10 |
| 1063901247 | Dominique J Carn | Technician, Other | 42000 Community Dr, Apt 2211, West Palm Beach, FL 33409 | 2018-05-03 |
| Find all providers in zip 33409 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043827694 | Medlife Supply LLC | Durable Medical Equipment & Medical Supplies | 1495 Forest Hill Blvd Ste C1, West Palm Beach, FL 33406-6073 | 2020-09-28 |
| 1346850005 | Metric Medical Solutions LLC | Durable Medical Equipment & Medical Supplies | 224 Datura St Ste 308, West Palm Beach, FL 33401-5631 | 2020-08-06 |
| 1245848175 | Horizon Med Supplies LLC | Durable Medical Equipment & Medical Supplies | 224 Datura St Ste 1107, West Palm Beach, FL 33401-5611 | 2020-07-16 |
| 1457979775 | Supportive Supplies LLC | Durable Medical Equipment & Medical Supplies | 224 Datura St Ste 307, West Palm Beach, FL 33401-5631 | 2020-07-13 |
| 1043838485 | Origin Medical LLC | Durable Medical Equipment & Medical Supplies | 224 Datura St Ste 1309, West Palm Beach, FL 33401-5641 | 2020-07-13 |
| 1285252924 | Tenet Florida Physician Services II, LLC | Durable Medical Equipment & Medical Supplies | 5352 Greenwood Ave, Ste 103, West Palm Beach, FL 33407 | 2020-07-09 |
| 1811515711 | Ally Medical Group LLC | Durable Medical Equipment & Medical Supplies | 2300 Palm Beach Lakes Blvd Ste 300a, West Palm Beach, FL 33409-3300 | 2020-07-08 |
| 1003430976 | Vita Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 224 Datura St Ste 209-210, West Palm Beach, FL 33401-5624 | 2020-06-05 |
| 1902435803 | Infinity Medical Equipment Group LLC | Durable Medical Equipment & Medical Supplies | 2101 Vista Pkwy # 105, West Palm Beach, FL 33411-2706 | 2020-04-03 |
| 1427689165 | Genesis Medical LLC | Durable Medical Equipment & Medical Supplies | 2101 Vista Pkwy Ste 220, West Palm Beach, FL 33411-2706 | 2020-01-31 |
| Find all providers in WEST PALM BEACH | ||||
| City | WEST PALM BEACH |
| Zip Code | 33409 |
Please comment or provide details below to improve the information on SOUTH FLORIDA MEDICAL STORE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.