Provider Demographics
NPI:1447291281
Name:GISELLE MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:GISELLE MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:V
Authorized Official - Last Name:GODOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-667-1215
Mailing Address - Street 1:13275 SW 136TH ST
Mailing Address - Street 2:UNIT # 13
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5825
Mailing Address - Country:US
Mailing Address - Phone:305-667-1215
Mailing Address - Fax:
Practice Address - Street 1:13275 SW 136TH ST UNIT 13
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5825
Practice Address - Country:US
Practice Address - Phone:305-667-1215
Practice Address - Fax:305-667-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001250OtherEPA ACCREDITATION
FL32 4397OtherOXYGEN LICENSE
FL307OtherAHCA LICENSE
FL001250OtherEPA ACCREDITATION