Active NPI
National Medical Equipment, Inc
- Durable Medical Equipment & Medical Supplies
- Medley, FL
National Provider Identifier
1528066628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 6644
- Legal business name
- NATIONAL MEDICAL EQUIPMENT, INC
- Practice address
- 12605 NW 115 Ave
B-102
Medley, FL 33178-3191 - Phone
- (305) 688-9991
- Fax
- (305) 687-4529
- NPI assigned
- Jul 12, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Antonio Raventos
- Title
- President
- Phone
- (305) 688-9991
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 6644 | FL | Primary |
Addresses
Primary practice location
12605 NW 115 Ave
B-102
Medley, FL 33178-3191
Mailing address
12605 NW 115 Ave
B-102
Medley, FL 33178-3191
Phone (305) 688-9991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027172100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930038533 | FL | DME Supplier - Medical Supply Company | 1153448899 | Practice locations: Medley, FL |
National Provider Directory
National Provider DirectoryLocations
12605 NW 115th Ave
#B102
Medley, FL 33178
Phone (305) 688-9991
12605 NW 115th Ave
Unit 102
Medley, FL 33178
Phone (305) 688-9991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1464220800000",
"number": "1528066628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12605 NW 115 AVE",
"address_2": "B-102",
"city": "MEDLEY",
"state": "FL",
"postal_code": "331783191",
"telephone_number": "305-688-9991",
"fax_number": "305-687-4529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12605 NW 115 AVE",
"address_2": "B-102",
"city": "MEDLEY",
"state": "FL",
"postal_code": "331783191",
"telephone_number": "305-688-9991",
"fax_number": "305-687-4529"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONAL MEDICAL EQUIPMENT, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-12",
"last_updated": "2016-05-26",
"status": "A",
"authorized_official_last_name": "RAVENTOS",
"authorized_official_first_name": "ANTONIO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "305-688-9991",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "FL",
"license": "6644",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "027172100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Medley, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.