Healthcare Provider Details

I. General information

NPI: 1831028554
Provider Name (Legal Business Name): SIX.FOUR.SIX TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 NE 20TH ST
GAINESVILLE FL
32641-5887
US

IV. Provider business mailing address

105 NE 20TH ST
GAINESVILLE FL
32641-5887
US

V. Phone/Fax

Practice location:
  • Phone: 386-366-5296
  • Fax:
Mailing address:
  • Phone: 386-366-5296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: MR. LORENZA BERNARD SIMMONS II
Title or Position: OWNER
Credential:
Phone: 386-366-5296