Provider Demographics
NPI:1447309141
Name:EXCEL RESPIRATORY SOLUTIONS, LLC
Entity type:Organization
Organization Name:EXCEL RESPIRATORY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RANDAL
Authorized Official - Last Name:HAGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-698-3111
Mailing Address - Street 1:334 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4002
Mailing Address - Country:US
Mailing Address - Phone:863-299-2500
Mailing Address - Fax:863-299-2511
Practice Address - Street 1:334 3RD ST NW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4002
Practice Address - Country:US
Practice Address - Phone:863-299-2500
Practice Address - Fax:863-299-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3204482332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9798OtherBLUE CROSSBLUE SHIELD
FL1312801OtherFL MEDICAL EQUIPMENT LIC
FL24002OtherWINTER HAVEN OCCP LIC
FL3204482OtherFL MEDICAL OXYGEN PERMIT
FL99700007892OtherPOLK COUNTY OCCP LIC
FL3204482OtherFL MEDICAL OXYGEN PERMIT