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General NPI Number Information
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NPI Number | 1508401456
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Entity Type | Organization
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Legal Business Name | MINA TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 6869 MERRYVALE LN APT 21104
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City | ORLANDO
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State | FL
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Zip | 32822-5094
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Country | US
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Telephone | 407-427-3091
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 720367
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City | ORLANDO
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State | FL
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Zip | 32872-0367
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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 | MANAGER
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Name | LUIS DOMINGUEZ
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Credential |
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Telephone | 407-427-3091
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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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