MEDICARE: CONNECT TO CARE OF FLORIDA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053088476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECT TO CARE OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	1225 W BEAVER ST STE 120
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-1415
Country	:	US
Telephone Number	:	904-648-6200
Fax Number	:	904-648-6300

Provider Business Practice Location Address
First Line	:	1225 W BEAVER ST STE 120
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-1415
Country	:	US
Telephone Number	:	904-648-6200
Fax Number	:	904-648-6300

Authorized Official
Title or Position	:	CEO
Name	:	CHARITA BRYANT
Credential	:
Telephone Number	:	904-648-6200

Provider Enumeration Date	:	08/24/2021
Last Update Date	:	10/04/2021

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Directions to “CONNECT TO CARE OF FLORIDA, LLC ” Practice Location

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