Diabetic Shoe Source Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · Debary, FL

NPI 1881056836 · NPPES record last updated Mar 28, 2016

Key facts

NPI
1881056836
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
NOT REQUIRED (FL)
Legal business name
DIABETIC SHOE SOURCE INC.
Practice address
156 S Charles Richard Beall Blvd
Suite 3
Debary, FL 32713-3273
Phone
(407) 323-5093
Fax
(407) 386-8074
NPI assigned
Mar 28, 2016
Organization subpart
No

Authorized official

Name
Anthony H Rivera, C. PED
Title
President
Phone
(407) 323-5093

National Provider Directory

Locations

156 S Charles Richard Beall Blvd
Ste 3
Debary, FL 32713
Phone (407) 323-5093

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NOT REQUIRED FL Yes

Addresses

Primary practice location

156 S Charles Richard Beall Blvd
Suite 3
Debary, FL 32713-3273

Mailing address

156 S Charles Richard Beall Blvd
Suite 3
Debary, FL 32713-3273
Phone (407) 323-5093

Other providers in Debary, FL

All providers in Debary, FL · Durable Medical Equipment & Medical Supplies in Florida

Sources for this page

Verify at the official NPI Registry.