Provider Demographics
NPI:1073935706
Name:RAGVILLE
Entity Type:Organization
Organization Name:RAGVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIXON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-372-1195
Mailing Address - Street 1:855 NE 205TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1906
Mailing Address - Country:US
Mailing Address - Phone:786-372-1195
Mailing Address - Fax:
Practice Address - Street 1:855 NE 205TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1906
Practice Address - Country:US
Practice Address - Phone:786-372-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL007431513347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle