Healthcare Provider Details

I. General information

NPI: 1487423042
Provider Name (Legal Business Name): T&J ON THE RUN TRANSPORT LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2023
Last Update Date: 01/13/2024
Certification Date: 01/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11806 BRUCE B DOWNS BLVD FL 33612
TAMPA FL
33612-5542
US

IV. Provider business mailing address

11806 BRUCE B DOWNS BLVD FL 33612
TAMPA FL
33612-5542
US

V. Phone/Fax

Practice location:
  • Phone: 813-699-0606
  • Fax:
Mailing address:
  • Phone: 813-699-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. JEHRARDD WILLIAMS
Title or Position: REGISTERED AGENT
Credential:
Phone: 813-699-0606