Provider Demographics
NPI:1861938086
Name:MODERN MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:MODERN MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-757-0790
Mailing Address - Street 1:1111 HYPOLUXO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-4271
Mailing Address - Country:US
Mailing Address - Phone:561-810-1690
Mailing Address - Fax:561-420-0052
Practice Address - Street 1:1111 HYPOLUXO RD STE 102
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-4271
Practice Address - Country:US
Practice Address - Phone:561-810-1690
Practice Address - Fax:561-420-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies