Provider Demographics
NPI:1487745162
Name:SOUTH TEAM SERVICE, INC.
Entity type:Organization
Organization Name:SOUTH TEAM SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-259-2085
Mailing Address - Street 1:12471 SW 130TH ST
Mailing Address - Street 2:#B11
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6236
Mailing Address - Country:US
Mailing Address - Phone:305-259-2085
Mailing Address - Fax:305-259-2073
Practice Address - Street 1:12471 SW 130TH ST
Practice Address - Street 2:#B11
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6236
Practice Address - Country:US
Practice Address - Phone:305-259-2085
Practice Address - Fax:305-259-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies