MEDICARE: KINETIC TRANSPORTATION CORP

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)

General Provider Information

NPI Number	:	1073358206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINETIC TRANSPORTATION CORP

Provider Business Mailing Address
First Line	:	3030 AVENUE O NW # B
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-2002
Country	:	US
Telephone Number	:	689-237-1886
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 AVENUE O NW # B
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-2002
Country	:	US
Telephone Number	:	689-237-1886
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEITH JONES
Credential	:
Telephone Number	:	689-237-1886

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/28/2024

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Directions to “KINETIC TRANSPORTATION CORP ” Practice Location

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