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General NPI Number Information
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NPI Number | 1487901104
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Entity Type | Organization
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Legal Business Name | MEDWAY EXPRESS
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 2520 CORAL WAY # 2087
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City | CORAL GABLES
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State | FL
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Zip | 33145-3438
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Country | US
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Telephone | 786-301-1108
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 CORAL WAY # 2087
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City | CORAL GABLES
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State | FL
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Zip | 33145-3438
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Country | US
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Telephone | 786-301-1108
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Fax |
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Authorized Official
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Title or Position | VP FIELD COORDINATOR
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Name | WILLIAM GONZALEZ
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Credential |
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Telephone | 786-301-1108
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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 | 692606-8
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License Number State | FL
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