Healthcare Provider Details

I. General information

NPI: 1770309205
Provider Name (Legal Business Name): EZ TRANSIT. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 ALOMA AVE APT N5
WINTER PARK FL
32792-3745
US

IV. Provider business mailing address

2774 E COLONIAL DR STE C1200
ORLANDO FL
32803-5025
US

V. Phone/Fax

Practice location:
  • Phone: 407-436-4440
  • Fax:
Mailing address:
  • Phone: 407-436-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: JORGE L ALICEA
Title or Position: OWNER
Credential:
Phone: 321-276-3933