MEDICARE: XEN MEDICAL TRANSPORT CORP

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	:	1972331379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XEN MEDICAL TRANSPORT CORP

Provider Business Mailing Address
First Line	:	14922 SW 173RD TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-6756
Country	:	US
Telephone Number	:	786-502-5229
Fax Number	:

Provider Business Practice Location Address
First Line	:	14922 SW 173RD TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-6756
Country	:	US
Telephone Number	:	786-502-5229
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IVAN ARQUEZ JR.
Credential	:
Telephone Number	:	786-502-5229

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	07/25/2024

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Directions to “XEN MEDICAL TRANSPORT CORP ” Practice Location

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