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General NPI Number Information
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NPI Number | 1124622618
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Entity Type | Organization
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Legal Business Name | MYERS SOUTHERN LLC
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 5263 AIRPORT BLVD
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City | BARTOW
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State | FL
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Zip | 33830-6615
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Country | US
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Telephone | 833-782-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 3814 SERENADE LN
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City | LAKELAND
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State | FL
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Zip | 33811-8600
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Country | US
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Telephone | 863-210-0097
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GREG HOWARD MYERS
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Credential |
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Telephone | 863-210-0097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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