Healthcare Provider Details

I. General information

NPI: 1396148821
Provider Name (Legal Business Name): EXQUIZEEK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 09/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2216 MARTINS RUN
TAVARES FL
32778-5182
US

IV. Provider business mailing address

2216 MARTINS RUN
TAVARES FL
32778
US

V. Phone/Fax

Practice location:
  • Phone: 352-638-7771
  • Fax:
Mailing address:
  • Phone: 352-638-7771
  • 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. DEVON ROSE
Title or Position: OWNER
Credential:
Phone: 352-638-7771