=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174074421
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MED JETS USA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2016
-----------------------------------------------------
Last Update Date | 10/21/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 E PALMETTO PARK RD STE 800
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33432-4833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-504-1093
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 150 E PALMETTO PARK RD STE 800
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33432-4833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. CARLOS TREVILLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 619-851-8377
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416A0800X
-----------------------------------------------------
Taxonomy Name | Air Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------