MEDICARE: BBC ENTERPRISES 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)

General Provider Information

NPI Number	:	1316571474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BBC ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	6827 N ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-4174
Country	:	US
Telephone Number	:	407-790-6753
Fax Number	:	407-308-0669

Provider Business Practice Location Address
First Line	:	6827 N ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-4174
Country	:	US
Telephone Number	:	407-243-7800
Fax Number	:	407-308-0669

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	NOSEBEN ROBERT
Credential	:
Telephone Number	:	407-243-7800

Provider Enumeration Date	:	02/27/2020
Last Update Date	:	02/28/2020

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