Healthcare Provider Details

I. General information

NPI: 1619885308
Provider Name (Legal Business Name): TID MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6058 WAYCROSS DR
SPRING HILL FL
34606-4649
US

IV. Provider business mailing address

1193 NW 133RD CT
MIAMI FL
33182-2216
US

V. Phone/Fax

Practice location:
  • Phone: 585-673-6658
  • Fax:
Mailing address:
  • Phone: 585-673-6658
  • 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: DANILO ALBA RICARD
Title or Position: MGR
Credential:
Phone: 585-673-6658