Organization Active NPI

Pro Services Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Winter Haven, FL
National Provider Identifier
1386268019
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PRO SERVICES MEDICAL SUPPLY LLC
Practice address
1339 Evergreen CT
Winter Haven, FL 33881-4448
Phone
(786) 251-7796
NPI assigned
May 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Eduardo A Delgado
Title
Manager Member
Phone
(786) 251-7796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1339 Evergreen CT
Winter Haven, FL 33881-4448

Mailing address

1339 Evergreen CT
Winter Haven, FL 33881-4448
Phone (786) 251-7796

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1386268019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 EVERGREEN CT",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814448",
            "telephone_number": "786-251-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 EVERGREEN CT",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814448",
            "telephone_number": "786-251-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SERVICES MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "786-251-7796"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.