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General NPI Number Information
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NPI Number | 1356804728
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Entity Type | Organization
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Legal Business Name | EBENEZER TRANSPORT SERVICES CORP,
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 3451 NW 48TH ST
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City | MIAMI
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State | FL
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Zip | 33142-3367
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Country | US
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Telephone | 305-914-0380
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Fax | 786-362-6273
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Provider Business Mailing Address
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Address Line | 3451 NW 48TH ST
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City | MIAMI
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State | FL
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Zip | 33142-3367
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Country | US
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Telephone | 305-914-0380
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Fax | 786-362-6273
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JULIO LOZADA
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Credential | V.P
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Telephone | 786-344-3718
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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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