MEDICARE: ALVAGARD TRANSPORT LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1063997500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALVAGARD TRANSPORT LLC.

Provider Business Mailing Address
First Line	:	2285 J LAWSON BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-4323
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2285 J LAWSON BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-4323
Country	:	US
Telephone Number	:	407-928-4298
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FRANCISCO ALVAREZ
Credential	:
Telephone Number	:	407-928-4298

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	10/01/2018

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