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General NPI Number Information
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NPI Number | 1740577550
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Entity Type | Organization
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Legal Business Name | LIFEFLEET SOUTHEAST, INC.
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 305 MAIN ST
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City | AUBURNDALE
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State | FL
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Zip | 33823-4113
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Country | US
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Telephone | 813-885-3955
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Fax | 813-885-5844
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Provider Business Mailing Address
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Address Line | PO BOX 402079
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City | ATLANTA
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State | GA
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Zip | 30384-2079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TIMOTHY DORN
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Credential |
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Telephone | 303-495-1517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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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 | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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