Provider Demographics
NPI:1255382172
Name:AXESS MEDICAL SUPPLY AND EQUIPMENT, INC.
Entity type:Organization
Organization Name:AXESS MEDICAL SUPPLY AND EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRISTOBAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-667-3390
Mailing Address - Street 1:6850 SW 24TH ST
Mailing Address - Street 2:403
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1758
Mailing Address - Country:US
Mailing Address - Phone:305-667-3390
Mailing Address - Fax:
Practice Address - Street 1:6850 SW 24TH ST
Practice Address - Street 2:403
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1758
Practice Address - Country:US
Practice Address - Phone:305-667-3390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312841332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5011590001Medicare ID - Type UnspecifiedPROVIDER NUMBER