Healthcare Provider Details

I. General information

NPI: 1164245700
Provider Name (Legal Business Name): PROTECTING ANGELS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NW 8TH AVE STE B5-1
GAINESVILLE FL
32601-5011
US

IV. Provider business mailing address

901 NW 8TH AVE STE B5-1
GAINESVILLE FL
32601-5011
US

V. Phone/Fax

Practice location:
  • Phone: 352-219-1661
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: AMANDA HENDERSON
Title or Position: OWNER
Credential:
Phone: 352-219-1661