MEDICARE: TOP MEDICAL TRANSPORTATION SERVICES 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	344600000X	Taxi

General Provider Information

NPI Number	:	1104300417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOP MEDICAL TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	P.O.BOX 822 FORT PIERCE
Second Line	:
City	:	FORT PIERCE FL
State	:	FL
Zip	:	34954
Country	:	US
Telephone Number	:	772-210-1063
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 N 37TH ST FL 34947
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-2503
Country	:	US
Telephone Number	:	772-210-1063
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SUPPLICE SOUFFRANT
Credential	:
Telephone Number	:	407-807-0530

Provider Enumeration Date	:	09/21/2018
Last Update Date	:	09/21/2018

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