Healthcare Provider Details

I. General information

NPI: 1932757762
Provider Name (Legal Business Name): NC ROYAL TRANSPORTATION CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25434 SW 122ND PL
HOMESTEAD FL
33032-5955
US

IV. Provider business mailing address

25434 SW 122ND PL
HOMESTEAD FL
33032-5955
US

V. Phone/Fax

Practice location:
  • Phone: 305-922-7235
  • Fax: 305-675-2668
Mailing address:
  • Phone: 305-922-7235
  • Fax: 305-675-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: NADINE O CRESPO
Title or Position: PRESIDENT
Credential:
Phone: 305-922-7235