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General NPI Number Information
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NPI Number | 1780984039
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Entity Type | Organization
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Legal Business Name | SUNNYVALE MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 4280 LAKEVIEW DR
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City | SEBRING
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State | FL
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Zip | 33870-2020
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Country | US
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Telephone | 863-381-3565
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Fax | 863-402-1155
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Provider Business Mailing Address
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Address Line | 4280 LAKEVIEW DR
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City | SEBRING
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State | FL
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Zip | 33870-2020
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Country | US
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Telephone | 863-381-3565
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Fax | 863-402-1155
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Authorized Official
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Title or Position | DON
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Name | MRS. KAREN L WHITE
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Credential |
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Telephone | 863-381-4367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | H160YD
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License Number State | FL
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