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General NPI Number Information
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NPI Number | 1821098492
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Entity Type | Organization
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Legal Business Name | VILLAGE OF TEQUESTA FLORIDA VILLAGE OF TEQUESTA
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 357 TEQUESTA DR
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City | TEQUESTA
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State | FL
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Zip | 33469-3088
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Country | US
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Telephone | 561-768-0550
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Fax | 561-768-0693
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Provider Business Mailing Address
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Address Line | 345 TEQUESTA DR
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City | TEQUESTA
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State | FL
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Zip | 33469-3062
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Country | US
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Telephone | 561-768-0550
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Fax | 561-768-0693
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. JOEL A MEDINA
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Credential |
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Telephone | 561-768-0550
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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 | 002551
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License Number State | FL
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