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General NPI Number Information
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NPI Number | 1669779880
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Entity Type | Organization
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Legal Business Name | GEORGES TRANSPORT
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 705 W MINNESOTA AVE
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City | ORANGE CITY
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State | FL
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Zip | 32763-2104
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Country | US
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Telephone | 386-456-0640
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Fax | 386-456-0640
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Provider Business Mailing Address
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Address Line | 705 W MINNESOTA AVE
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City | ORANGE CITY
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State | FL
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Zip | 32763-2104
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Country | US
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Telephone | 386-456-0640
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Fax | 386-456-0640
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Authorized Official
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Title or Position | OWNER/ OPERATOR
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Name | MR. GEORGE GLENWOOD TORRES I
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Credential | PRES
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Telephone | 386-456-0640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number | T620-307-46-290-0
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License Number State | FL
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