MEDICARE: MAX CARE TRANSPORTATION 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	:	1356177646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAX CARE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	103 CENTURY 21 DR STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-9256
Country	:	US
Telephone Number	:	904-646-8698
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 CENTURY 21 DR STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-9256
Country	:	US
Telephone Number	:	904-646-8698
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AHMED ELTOUKHY
Credential	:
Telephone Number	:	904-646-8698

Provider Enumeration Date	:	09/12/2024
Last Update Date	:	09/14/2024

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