MEDICARE: AURORA SKY 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1295519338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURORA SKY TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	1235 PROVIDENCE BLVD # R1170
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-7363
Country	:	US
Telephone Number	:	407-906-4556
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 PROVIDENCE BLVD # R1170
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-7363
Country	:	US
Telephone Number	:	407-906-4556
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. OLIVER LINCOLN FARARA
Credential	:
Telephone Number	:	386-717-4043

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/21/2023

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