Ideal Life US Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IDEAL LIFE US INC.

Practice address

2110 N Ocean Blvd Ste 12D
Fort Lauderdale, FL 33305-1947

Phone

(888) 433-2541

Fax

(416) 489-3009

NPI assigned

Dec 23, 2011

Organization subpart

No

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

Authorized official

Name

Jason Gioldberg

Title

President

Phone

(888) 433-2541

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1306115076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 N OCEAN BLVD STE 12D",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051947",
            "telephone_number": "888-433-2541",
            "fax_number": "416-489-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N OCEAN BLVD STE 12D",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051947",
            "telephone_number": "888-433-2541",
            "fax_number": "416-489-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL LIFE US INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "GIOLDBERG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-433-2541"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.