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General NPI Number Information
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NPI Number | 1710588769
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Entity Type | Organization
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Legal Business Name | ELSY LLC
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 600 GOLDEN SUNSHINE CIR
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City | ORLANDO
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State | FL
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Zip | 32807-3456
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Country | US
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Telephone | 407-914-9530
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Fax |
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Provider Business Mailing Address
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Address Line | 600 GOLDEN SUNSHINE CIR
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City | ORLANDO
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State | FL
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Zip | 32807-3456
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Country | US
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Telephone | 407-914-9530
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Fax |
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Authorized Official
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Title or Position | NEMT
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Name | ELOISA ALEXIS FARIAS RIOS
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Credential |
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Telephone | 407-914-9530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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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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