Healthcare Provider Details

I. General information

NPI: 1578655338
Provider Name (Legal Business Name): VILLAGE OF KEY BISCAYNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 10/19/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 CRANDON BLVD
KEY BISCAYNE FL
33149-1832
US

IV. Provider business mailing address

PO BOX 919806
ORLANDO FL
32862-9806
US

V. Phone/Fax

Practice location:
  • Phone: 305-365-8989
  • Fax: 305-365-8933
Mailing address:
  • Phone: 305-365-8989
  • Fax: 305-365-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberALS 1320
License Number StateFL

VIII. Authorized Official

Name: ERIC LANG
Title or Position: FIRE CHIEF
Credential:
Phone: 305-365-8989