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General NPI Number Information
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NPI Number | 1912905829
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Entity Type | Organization
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Legal Business Name | ISLAMORADA VILLAGE OF ISLANDS A FLORIDA MUNICIPALITY
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 86800 OVERSEAS HWY
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City | ISLAMORADA
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State | FL
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Zip | 33036-3162
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Country | US
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Telephone | 305-664-6490
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Fax | 305-852-5195
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Provider Business Mailing Address
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Address Line | 420 WALMART WAY PMB 510
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City | DAHLONEGA
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State | GA
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Zip | 30533-0818
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Country | US
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Telephone | 877-288-8561
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Fax | 866-889-1258
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. WILLIAM A WAGNER III
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Credential |
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Telephone | 305-664-6490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | ALS4406
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License Number State | FL
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