MEDICARE: AAA MEDICAL TRANSPORT SERVICES, 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)	G09000135700	FL

General Provider Information

NPI Number	:	1992019517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA MEDICAL TRANSPORT SERVICES, INC

Provider Business Mailing Address
First Line	:	3884 HAMPTON HILLS DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3839
Country	:	US
Telephone Number	:	863-669-8096
Fax Number	:	863-816-3394

Provider Business Practice Location Address
First Line	:	3884 HAMPTON HILLS DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3839
Country	:	US
Telephone Number	:	863-669-8096
Fax Number	:	863-816-3394

Authorized Official
Title or Position	:	VP/SECRETARY
Name	:	MR. JOSE DELOS SANTOS INOCENTE
Credential	:	LMT
Telephone Number	:	941-545-2031

Provider Enumeration Date	:	08/06/2010
Last Update Date	:	08/06/2010

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