Provider Demographics
NPI:1376573048
Name:FLORIDA HOSPITAL DME/RT, LLC
Entity type:Organization
Organization Name:FLORIDA HOSPITAL DME/RT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-865-5489
Mailing Address - Street 1:556 FLORIDA CENTRAL PKWY
Mailing Address - Street 2:STE 1060
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5174
Mailing Address - Country:US
Mailing Address - Phone:407-830-1938
Mailing Address - Fax:407-830-0936
Practice Address - Street 1:556 FLORIDA CENTRAL PKWY
Practice Address - Street 2:STE 1060
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5174
Practice Address - Country:US
Practice Address - Phone:407-830-1938
Practice Address - Fax:407-830-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312791332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5591840001Medicare NSC