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General NPI Number Information
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NPI Number | 1205486834
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Entity Type | Organization
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Legal Business Name | SUPER FAST LIMOUSINE
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 4409 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-6837
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Country | US
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Telephone | 718-438-6262
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Fax | 718-853-3446
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Provider Business Mailing Address
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Address Line | 4405 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-6838
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Country | US
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Telephone | 718-438-6262
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Fax | 718-853-3446
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAUL IZQUIERDO
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Credential |
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Telephone | 718-690-4306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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