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General NPI Number Information
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NPI Number | 1770308512
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Entity Type | Organization
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Legal Business Name | ELITE PPEC TRANSPORT LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 411 S 21ST AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5013
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Country | US
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Telephone | 754-263-2925
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Fax | 954-416-7963
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Provider Business Mailing Address
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Address Line | 411 S 21ST AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5013
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Country | US
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Telephone | 754-263-2925
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Fax | 954-416-7963
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ISSETTE BORREGO
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Credential |
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Telephone | 754-263-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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