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General NPI Number Information
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NPI Number | 1376816835
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Entity Type | Organization
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Legal Business Name | EDMT CORPORATION
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 921 N 21ST AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-3535
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Country | US
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Telephone | 954-670-9630
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Fax |
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Provider Business Mailing Address
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Address Line | 921 N 21ST AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-3535
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Country | US
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Telephone | 954-670-9630
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ENRIQUE J APONTE
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Credential | A153-210-72-132-0
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Telephone | 954-670-9630
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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 | LL1160
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License Number State | FL
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