SPK Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPK MEDICAL SUPPLIES LLC

Practice address

370 Camino Gardens Blvd Ste 117
Boca Raton, FL 33432-5826

Phone

(888) 213-5069

NPI assigned

Nov 19, 2021

Organization subpart

No

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

Authorized official

Name

Robert Matthew Clark

Title

Owner

Phone

(888) 213-5069

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1720745219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 CAMINO GARDENS BLVD STE 117",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CAMINO GARDENS BLVD STE 117",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325826",
            "telephone_number": "888-213-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPK MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-213-5069"
    },
    "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 Nov 19, 2021; 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.