Healthcare Provider Details

I. General information

NPI: 1396529194
Provider Name (Legal Business Name): GATOR TRANSPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7968 SW 62ND CT
GAINESVILLE FL
32608-0169
US

IV. Provider business mailing address

7968 SW 62ND CT
GAINESVILLE FL
32608-0169
US

V. Phone/Fax

Practice location:
  • Phone: 813-820-8537
  • Fax:
Mailing address:
  • Phone: 813-820-8537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS CLISVEL R SILVA
Title or Position: OWNER/MANAGER
Credential:
Phone: 813-820-8537