Seventeen Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SEVENTEEN MEDICAL SUPPLY LLC

Practice address

6801 Lake Worth Rd Ste 126
Greenacres, FL 33467-2971

Phone

(561) 408-4324

NPI assigned

May 26, 2023

Organization subpart

No

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

Authorized official

Name

Aleixis Acosta

Title

Owner

Phone

(561) 985-3152

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1457044406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 126",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672971",
            "telephone_number": "561-408-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 126",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672971",
            "telephone_number": "561-408-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVENTEEN MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ALEIXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-985-3152"
    },
    "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 Jun 2, 2023; 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.