Queens Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

QUEENS MEDICAL SUPPLY LLC

Practice address

16772 NE 5TH Ave
N Miami Beach, FL 33162-3928

Phone

(954) 289-2169

NPI assigned

Dec 19, 2016

Organization subpart

No

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

Authorized official

Name

Kenneth Lee Dor

Title

Owner

Phone

(954) 289-2169

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1497299929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16772 NE 5TH AVE",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623928",
            "telephone_number": "954-289-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16772 NE 5TH AVE",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623928",
            "telephone_number": "954-289-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "DOR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-289-2169"
    },
    "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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• Durable Medical Equipment & Medical Supplies in N Miami Beach, FL
• Providers in N Miami Beach, 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 Feb 18, 2019; 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.