MEDICARE: LETSMEDIC

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	:	1376223438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LETSMEDIC

Provider Business Mailing Address
First Line	:	1628 E SOUTHERN AVE STE 9520
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-5782
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 E SOUTHERN AVE STE 9520
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-5782
Country	:	US
Telephone Number	:	480-798-4947
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DRIVER
Name	:	JESUS DE LA LUZ
Credential	:
Telephone Number	:	480-798-4947

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	07/24/2023

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Directions to “LETSMEDIC ” Practice Location

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