Certified Diabetic & Medical Services, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

CERTIFIED DIABETIC & MEDICAL SERVICES, INC

Doing business as

Certified Diabetic & Medical Supplies

Practice address

190 Fortenberry Rd
Suite 102
Merritt Island, FL 32952-3401

Phone

(321) 459-3882

Fax

(321) 454-4614

NPI assigned

Jun 1, 2006

Last updated

Feb 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cathy Liebsch

Title

President

Phone

(321) 459-3882

Specialties & licenses 1

Addresses

Other names 1

• Certified Diabetic & Medical Supplies Doing business as

Locations

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1265479018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 FORTENBERRY RD",
            "address_2": "SUITE 102",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523401",
            "telephone_number": "321-459-3882",
            "fax_number": "321-454-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 FORTENBERRY RD",
            "address_2": "SUITE 102",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523401",
            "telephone_number": "321-459-3882",
            "fax_number": "321-454-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED DIABETIC & MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "LIEBSCH",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-459-3882",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Certified Diabetic & Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Certified Diabetic & Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Lee Caudill, DMD, MSD, PA
• Kimberlee Ann Cavanaugh, ARNP-C
• CDPG, P.L. (Christie Dental of Merritt Island)
• Cedar Creek Assisted Living LLC
• Central Florida Holistic Health and Wellness Consultants LLC (Healthy Healing Acupuncture)
• Jean M Cervini-Koby, ARNP-FNP-C
• Amber Diane Chambers, APRN CNM
• Virginia Chan, PT
• Phyllis Chang
• Brianna Cheatham

• Prosthetic/Orthotic Supplier in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.