Healthcare Provider Details

I. General information

NPI: 1477810703
Provider Name (Legal Business Name): DIPLOMAT MEDICAL TRANSPORTATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 15TH ST E
BRADENTON FL
34203-6100
US

IV. Provider business mailing address

5421 15TH ST E
BRADENTON FL
34203-6100
US

V. Phone/Fax

Practice location:
  • Phone: 941-365-8294
  • Fax: 941-757-0288
Mailing address:
  • Phone: 941-365-8294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. JORGE RESENDIZ
Title or Position: PRESIDENT
Credential:
Phone: 941-365-8294