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General NPI Number Information
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NPI Number | 1639933245
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Entity Type | Organization
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Legal Business Name | FLORIDA TRANSPORTATION SERVICES CORP
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 302 W PALM DR
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City | HOMESTEAD
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State | FL
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Zip | 33034-3344
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Country | US
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Telephone | 305-742-1622
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Fax |
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Provider Business Mailing Address
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Address Line | 302 W PALM DR
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City | HOMESTEAD
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State | FL
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Zip | 33034-3344
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Country | US
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Telephone | 305-742-1622
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MR. YOVANI PEREZ
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Credential |
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Telephone | 305-742-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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