Provider Demographics
NPI:1902455959
Name:FLORIDA USA SUPPLIES INC
Entity Type:Organization
Organization Name:FLORIDA USA SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:CASTELLANO BLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-474-3030
Mailing Address - Street 1:17325 NW 27TH AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-4012
Mailing Address - Country:US
Mailing Address - Phone:305-474-3030
Mailing Address - Fax:305-474-3006
Practice Address - Street 1:17325 NW 27TH AVE STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-4012
Practice Address - Country:US
Practice Address - Phone:305-474-3030
Practice Address - Fax:305-474-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies