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General NPI Number Information
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NPI Number | 1669047122
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Entity Type | Organization
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Legal Business Name | BEACON OF LIGHT TRANSPORTATION, LLC
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 11534 ASHTON FIELD AVE
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City | RIVERVIEW
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State | FL
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Zip | 33579-2374
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Country | US
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Telephone | 813-493-0051
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Fax |
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Provider Business Mailing Address
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Address Line | 11534 ASHTON FIELD AVE
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City | RIVERVIEW
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State | FL
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Zip | 33579-2374
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Country | US
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Telephone | 813-493-0051
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SEAN HENDLEY
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Credential |
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Telephone | 813-493-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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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 | 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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