MEDICARE: GLOBAL MEDICAL ASSISTANCE, 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	3416A0800X	Air Ambulance

General Provider Information

NPI Number	:	1528599495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL MEDICAL ASSISTANCE, LLC

Provider Business Mailing Address
First Line	:	8801 HUNTERS LAKE DR
Second Line	:	UNIT 1212
City	:	TAMPA
State	:	FL
Zip	:	33647-2847
Country	:	US
Telephone Number	:	813-808-0664
Fax Number	:

Provider Business Practice Location Address
First Line	:	8801 HUNTERS LAKE DR
Second Line	:	UNIT 1212
City	:	TAMPA
State	:	FL
Zip	:	33647-2847
Country	:	US
Telephone Number	:	813-808-0664
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. RICHARD WALTER WELLENS
Credential	:	RN
Telephone Number	:	813-808-0664

Provider Enumeration Date	:	03/23/2017
Last Update Date	:	03/23/2017

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