MEDICARE: SOOUTH FLORIDA HEART TRANSPORTATION

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	:	1720240930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOOUTH FLORIDA HEART TRANSPORTATION

Provider Business Mailing Address
First Line	:	2751 S OCEAN DR
Second Line	:	SUITE S1506
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2721
Country	:	US
Telephone Number	:	954-923-3624
Fax Number	:

Provider Business Practice Location Address
First Line	:	2751 S OCEAN DR
Second Line	:	SUITE S1506
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2721
Country	:	US
Telephone Number	:	954-923-3624
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. FELIX MITNITSKY
Credential	:
Telephone Number	:	305-796-2720

Provider Enumeration Date	:	06/29/2008
Last Update Date	:	06/29/2008

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