Healthcare Provider Details

I. General information

NPI: 1154184885
Provider Name (Legal Business Name): WELLNESS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 KISMET AVE
PAHOKEE FL
33476-1318
US

IV. Provider business mailing address

360 KISMET AVE
PAHOKEE FL
33476-1318
US

V. Phone/Fax

Practice location:
  • Phone: 305-728-9287
  • Fax:
Mailing address:
  • Phone: 305-728-9287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: PERLA SEQUEIRA
Title or Position: OWNER
Credential:
Phone: 305-728-9287