MEDICARE: NARCISSE MOBILTY CARE 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	:	1760191761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NARCISSE MOBILTY CARE LLC

Provider Business Mailing Address
First Line	:	7127 GRAY SHADOW ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-8350
Country	:	US
Telephone Number	:	407-844-7962
Fax Number	:

Provider Business Practice Location Address
First Line	:	4640 OLD WINTER GARDEN RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-1784
Country	:	US
Telephone Number	:	689-251-0672
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. JOHNNY NARCISSE
Credential	:
Telephone Number	:	407-844-7962

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	11/17/2022

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