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General NPI Number Information
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NPI Number | 1003670183
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Entity Type | Organization
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Legal Business Name | ANJOLE MOTORSPORT, LLC
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 2555 NW 102ND AVE STE 203
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City | DORAL
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State | FL
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Zip | 33172-2131
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Country | US
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Telephone | 305-315-2195
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Fax | 305-315-2197
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Provider Business Mailing Address
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Address Line | 2555 NW 102ND AVE STE 203
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City | DORAL
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State | FL
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Zip | 33172-2131
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Country | US
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Telephone | 305-315-2195
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Fax | 305-315-2197
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Authorized Official
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Title or Position | OWNER
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Name | LEIDY ABAD
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Credential |
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Telephone | 786-527-4341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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