MEDICARE: FLORIDA MEDTRANS CORPORATION

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)		FL

General Provider Information

NPI Number	:	1487892824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA MEDTRANS CORPORATION

Provider Business Mailing Address
First Line	:	6839 KNIGHTSWOOD DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-8872
Country	:	US
Telephone Number	:	407-797-8674
Fax Number	:	407-915-4003

Provider Business Practice Location Address
First Line	:	6839 KNIGHTSWOOD DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-8872
Country	:	US
Telephone Number	:	407-797-8674
Fax Number	:	407-915-4003

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. KEITH BERNARD MILLER
Credential	:
Telephone Number	:	407-797-8674

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	01/22/2009

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Directions to “FLORIDA MEDTRANS CORPORATION ” Practice Location

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