Healthcare Provider Details

I. General information

NPI: 1841686854
Provider Name (Legal Business Name): CLASSIC TRANSPORTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 W WATERS AVE
TAMPA FL
33604-2947
US

IV. Provider business mailing address

233 W WATERS AVE
TAMPA FL
33604-2947
US

V. Phone/Fax

Practice location:
  • Phone: 813-886-8985
  • Fax:
Mailing address:
  • Phone: 813-886-8985
  • 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: MR. JUAN ENRIQUE PEREZ
Title or Position: PRESIDENT
Credential:
Phone: 813-299-6322