Healthcare Provider Details

I. General information

NPI: 1821311374
Provider Name (Legal Business Name): AIR CRITICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25591 TECHNOLOGY BLVD UNIT A
PUNTA GORDA FL
33950-4701
US

IV. Provider business mailing address

25591 TECHNOLOGY BLVD UNIT A
PUNTA GORDA FL
33950-4701
US

V. Phone/Fax

Practice location:
  • Phone: 941-639-9119
  • Fax: 941-761-5838
Mailing address:
  • Phone: 941-639-9119
  • Fax: 941-761-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAELA A PEAT
Title or Position: MANAGER
Credential: EMT-S
Phone: 941-639-9119