MEDICARE: RYSING ABOVE TRANSPORTATION 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1881299691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYSING ABOVE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	6809 41ST AVE N
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-5805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6809 41ST AVE N
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-5805
Country	:	US
Telephone Number	:	305-376-1181
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXIS MILLER
Credential	:
Telephone Number	:	305-376-1181

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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