Healthcare Provider Details

I. General information

NPI: 1841731775
Provider Name (Legal Business Name): ON TIME MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2017
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15160 SW 136TH ST UNIT 10
MIAMI FL
33196-2664
US

IV. Provider business mailing address

2549 CEDAR LAKES DR
RIPLEY WV
25271-6551
US

V. Phone/Fax

Practice location:
  • Phone: 304-373-3145
  • Fax:
Mailing address:
  • Phone: 304-373-3145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: HUGO RENE OLIVARES
Title or Position: CEO
Credential:
Phone: 786-556-4466