MEDICARE: RYDE'S 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	343900000X	Non-emergency Medical Transport (VAN)
2	343900000X	Non-emergency Medical Transport (VAN)	G524421600930	FL

General Provider Information

NPI Number	:	1104325638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYDE'S TRANSPORT LLC

Provider Business Mailing Address
First Line	:	45 SOVEREIGN WAY
Second Line	:
City	:	HUTCHINSON ISLAND
State	:	FL
Zip	:	34949-8367
Country	:	US
Telephone Number	:	772-370-0101
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 SOVEREIGN WAY
Second Line	:
City	:	HUTCHINSON ISLAND
State	:	FL
Zip	:	34949-8367
Country	:	US
Telephone Number	:	772-370-0101
Fax Number	:

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	JOSE ANTONIO GONZALEZ
Credential	:
Telephone Number	:	772-370-0101

Provider Enumeration Date	:	02/11/2018
Last Update Date	:	02/11/2018

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