MEDICARE: PRO2CALL MEDICAL TRANSPORT

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	:	1982422838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO2CALL MEDICAL TRANSPORT

Provider Business Mailing Address
First Line	:	454 LAKE HARRIS DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-2689
Country	:	US
Telephone Number	:	863-393-7222
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 LAKE HARRIS DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-2689
Country	:	US
Telephone Number	:	863-393-7222
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSIE PERLADO
Credential	:
Telephone Number	:	863-393-7222

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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Directions to “PRO2CALL MEDICAL TRANSPORT ” Practice Location

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