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General NPI Number Information
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NPI Number | 1336953322
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Entity Type | Organization
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Legal Business Name | BACK2LIFE TRANSPORTATION LLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1104 SLEEPY OAK DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-7173
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Country | US
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Telephone | 850-694-0573
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Fax |
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Provider Business Mailing Address
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Address Line | 19046 BRUCE B DOWNS BLVD # 143
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City | TAMPA
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State | FL
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Zip | 33647-2434
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIMONE WILLIAMS
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Credential |
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Telephone | 850-694-0573
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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 |
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License Number State |
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