Healthcare Provider Details
I. General information
NPI: 1093166449
Provider Name (Legal Business Name): RELIABLE MEDICAL RESPONSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1534 BLUE MAGNOLIA RD
BRANDON FL
33510-4024
US
IV. Provider business mailing address
1534 BLUE MAGNOLIA RD
BRANDON FL
33510-4024
US
V. Phone/Fax
- Phone: 813-759-3283
- Fax:
- Phone: 813-759-3283
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | 5250-675 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 5250-675 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
DAVID
ORSBURN
HUGHES
JR.
Title or Position: MANAGING MEMBER
Credential: NREMT
Phone: 813-759-3283