=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316977135
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RURAL METRO OF NORTH FLORIDA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/04/2006
-----------------------------------------------------
Last Update Date | 10/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4930 GLOVER LANE
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-626-8634
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 532449
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30353-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MICHAEL P DIMINO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 480-606-3600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | ALS1704
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------