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General NPI Number Information
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NPI Number | 1538723747
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Entity Type | Individual
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Provider Name | JOHN PAYNE
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Gender | Male
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 2894 CATHERINE DR
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City | CLEARWATER
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State | FL
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Zip | 33759-2004
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Country | US
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Telephone | 727-831-6060
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Fax | 727-443-4050
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Provider Business Mailing Address
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Address Line | 2894 CATHERINE DR
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City | CLEARWATER
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State | FL
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Zip | 33759-2004
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Country | US
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Telephone | 727-831-6060
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Fax | 727-443-4050
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3346YS
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License Number State | FL
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