MEDICARE: AERO AMBULANCE INTERNATIONAL, INC

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	:	1710166822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AERO AMBULANCE INTERNATIONAL, INC

Provider Business Mailing Address
First Line	:	1511 E COMMERCIAL BLVD
Second Line	:	#35
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-5717
Country	:	US
Telephone Number	:	954-351-0757
Fax Number	:	954-337-3358

Provider Business Practice Location Address
First Line	:	1511 E COMMERCIAL BLVD
Second Line	:	#35
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-5717
Country	:	US
Telephone Number	:	954-351-0757
Fax Number	:	954-337-3358

Authorized Official
Title or Position	:	FLIGHT COORDINATOR
Name	:	MR. RIC LOPEZ
Credential	:
Telephone Number	:	954-351-0757

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	10/25/2007

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