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General NPI Number Information
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NPI Number | 1154885978
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Entity Type | Individual
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Provider Name | KRASIMIR IVANOV PASHALIEV
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Gender | Male
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 01/25/2019
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Provider Practice Location Address
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Address Line | 109 MELVIN ST
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City | DESTIN
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State | FL
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Zip | 32541-2338
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Country | US
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Telephone | 850-368-9890
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Fax |
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Provider Business Mailing Address
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Address Line | 247 BENT ARROW DR
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City | DESTIN
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State | FL
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Zip | 32541-2551
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Country | US
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Telephone | 850-368-9890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | P241-509-77-214-0
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | P241-509-77-214-0
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License Number State | FL
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