Healthcare Provider Details

I. General information

NPI: 1144603770
Provider Name (Legal Business Name): MARBELLA MEDICAL TRANSPORT & PRIVATE SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E SLIGH AVE
TAMPA FL
33604-5547
US

IV. Provider business mailing address

215 E SLIGH AVE
TAMPA FL
33604-5547
US

V. Phone/Fax

Practice location:
  • Phone: 813-770-8443
  • Fax:
Mailing address:
  • Phone: 813-770-8443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateFL

VIII. Authorized Official

Name: MARIE C FLORES
Title or Position: OWNER
Credential: MRS
Phone: 813-770-8443