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General NPI Number Information
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NPI Number | 1255376497
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Entity Type | Organization
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Legal Business Name | AMBITRANS MEDICAL TRANSPORT , INC.
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 4351 PINNACLE ST
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-2902
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Country | US
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Telephone | 941-743-3665
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Fax | 941-629-2193
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Provider Business Mailing Address
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Address Line | 4351 PINNACLE ST
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-2902
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Country | US
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Telephone | 941-743-3665
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Fax | 941-629-7314
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. ALAN J. SKAVRONECK
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Credential |
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Telephone | 941-613-6427
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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 | 2639
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | ALS0804
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License Number State | FL
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