Java Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

JAVA MEDICAL SUPPLY LLC

Practice address

1975 E Sunrise Blvd Ste 690
Fort Lauderdale, FL 33304-1454

Phone

(786) 742-5322

NPI assigned

Mar 5, 2021

Organization subpart

No

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

Authorized official

Name

Timothy Siuda

Title

Owner

Phone

(786) 742-5322

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1235724709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 E SUNRISE BLVD STE 690",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041454",
            "telephone_number": "786-742-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 E SUNRISE BLVD STE 690",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041454",
            "telephone_number": "786-742-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVA MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "SIUDA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-742-5322"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarrod S. Wilner, DC, PA
• Jason E. Portnof DMD, MD, PA
• Jason Evans, PA
• Bernadette A Jasper, LMHC, CAP
• Isabel Jaszewski, MD
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• Daiana Jazon, CRNA
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• Durable Medical Equipment & Medical Supplies in Fort Lauderdale, FL
• Providers in Fort Lauderdale, 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 Mar 5, 2021; 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.