Healthcare Provider Details

I. General information

NPI: 1366200719
Provider Name (Legal Business Name): PATIENT TRANSPORT OF NAPLES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4990 GOLDEN GATE PKWY
NAPLES FL
34116-6962
US

IV. Provider business mailing address

4990 GOLDEN GATE PKWY
NAPLES FL
34116-6962
US

V. Phone/Fax

Practice location:
  • Phone: 239-692-8309
  • Fax:
Mailing address:
  • Phone: 239-692-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAVARE D TAVAR
Title or Position: CEO
Credential: PA
Phone: 239-692-8309