Imajica Mottley Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IMAJICA MOTTLEY MEDICAL SUPPLY

Doing business as

Imajica Mottley MEDICAL SUPPLY

Practice address

417 Silver Beach Rd
Lake Park, FL 33403-3324

Phone

(813) 497-2959

Fax

(813) 592-6728

NPI assigned

Apr 18, 2025

Organization subpart

No

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

Authorized official

Name

Imajica Mottley

Title

President

Phone

(813) 497-2959

Specialties & licenses 1

Addresses

Other names 1

• Imajica Mottley MEDICAL SUPPLY Doing business as

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1225824857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 SILVER BEACH RD",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334033324",
            "telephone_number": "813-497-2959",
            "fax_number": "813-592-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SILVER BEACH RD",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334033324",
            "telephone_number": "813-497-2959",
            "fax_number": "813-592-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAJICA MOTTLEY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "MOTTLEY",
        "authorized_official_first_name": "IMAJICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-497-2959"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imajica Mottley MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Lake Park, FL
• Providers in Lake Park, 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 Apr 18, 2025; 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.