Certified Diabetic Supplies, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

F97000004927 Issued in FL

Legal business name

CERTIFIED DIABETIC SUPPLIES, INC

Practice address

10061 Amberwood Rd
Fort Myers, FL 33913-8502

Phone

(239) 430-5000

Fax

(800) 529-0543

NPI assigned

Jun 19, 2006

Organization subpart

Yes

Parent organization

CERTIFIED DIABETIC SERVICES, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lowell M. Fisher Jr.

Title

Chairman & Ceo

Phone

(239) 430-5000

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Certified Diabetic Services Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1093750218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10061 AMBERWOOD RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138502",
            "telephone_number": "239-430-5000",
            "fax_number": "800-529-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10061 AMBERWOOD RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138502",
            "telephone_number": "239-430-5000",
            "fax_number": "800-529-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED DIABETIC SUPPLIES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CERTIFIED DIABETIC SERVICES, INC.",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "LOWELL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHAIRMAN & CEO",
        "authorized_official_telephone_number": "239-430-5000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "F97000004927",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951571200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gustavo Cepero
• Cephas Medical Center
• Justin Ryan Ceravolo, PHARM.D.
• Elina Majela Cernuda Canizares
• Certified Diabetic Services
• David Cervantes, M.D., PH.D
• Jaime Cervera
• Cerwinsky Chiropractic Center
• James Cesare IV
• Jason Steven Cesario, M.D.

• Durable Medical Equipment & Medical Supplies in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.