Legacy Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LEGACY MEDICAL SUPPLY LLC

Practice address

10101 W Sample Rd Ste 108
Coral Springs, FL 33065-3907

Phone

(954) 932-0069

Fax

(954) 932-0068

NPI assigned

Jan 21, 2020

Organization subpart

No

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

Authorized official

Name

Michael Gomez

Title

Owner

Phone

(954) 932-0069

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1801426614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 W SAMPLE RD STE 108",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W SAMPLE RD STE 108",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653907",
            "telephone_number": "954-932-0069",
            "fax_number": "954-932-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-932-0069"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey H. Lee, EDD
• Tse C Lee, M.D.
• Legacy Advanced Health LLC
• Legacy Community Center LLC
• Legacy Medical Associates Incorporated
• Janine Legaspi
• Giselle Leibovitch, PHD
• Leila C. Morris, M.D., P.a.
• Beth M Leitner, PSY.D.
• Belize Leiva

• Durable Medical Equipment & Medical Supplies in Coral Springs, FL
• Providers in Coral Springs, 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 Jul 27, 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.