| Entity Name: | AUSTIN MEDICAL SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Nov 1994 (30 years ago) |
| Document Number: | P94000087267 |
| FEI/EIN Number | 650542804 |
| Address: | 5327 NORTHWEST 36 AVENUE, MIAMI, FL, 33142, US |
| Mail Address: | 5327 NW 36 AVE, MIAMI, FL, 33142, US |
| ZIP code: | 33142 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861484958 | 2005-08-16 | 2011-04-04 | 5327 NW 36TH AVE, MIAMI, FL, 331423205, US | 5327 NW 36TH AVE, MIAMI, FL, 331423205, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Name | MARTHA REYES |
| Role | PRESIDENT |
| Phone | 3056387996 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 715 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 321289 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 951827400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| REYES MARTHA N | Agent | 1860 NE 124 ST, NORTH MIAMI, FL, 33181 |
| Name | Role | Address |
|---|---|---|
| REYES MARTHA | President | 5327 NW 36 AVE, MIAMI, FL, 33142 |
| Name | Role | Address |
|---|---|---|
| REYES MARTHA | Secretary | 5327 NW 36 AVE, MIAMI, FL, 33142 |
| Name | Role | Address |
|---|---|---|
| REYES MARTHA | Director | 5327 NW 36 AVE, MIAMI, FL, 33142 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2021-10-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 1996-07-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
