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General NPI Number Information
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NPI Number | 1972132082
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Entity Type | Organization
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Legal Business Name | EXPRESS-MED, LLC
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 12916 PARKINGTON DR
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City | GIBSONTON
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State | FL
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Zip | 33534-3914
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Country | US
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Telephone | 813-850-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 W HILLSBOROUGH AVE STE 152772
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City | TAMPA
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State | FL
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Zip | 33614-5940
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Country | US
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Telephone | 813-850-3494
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDY MAURELL MONTERO
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Credential |
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Telephone | 813-850-3494
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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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