Healthcare Provider Details

I. General information

NPI: 1558748855
Provider Name (Legal Business Name): ANGEL FLIGHTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10294 SHADY OAK LANE
SEMINOLE FL
33777
US

IV. Provider business mailing address

10294 SHADY OAK LANE
SEMINOLE FL
33777
US

V. Phone/Fax

Practice location:
  • Phone: 727-528-8496
  • Fax:
Mailing address:
  • Phone: 727-528-8496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: ALEC WALLACE
Title or Position: MGR.
Credential:
Phone: 727-954-8170