Provider Demographics
NPI:1083384408
Name:CITRUS MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:CITRUS MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-476-5587
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34487-0186
Mailing Address - Country:US
Mailing Address - Phone:352-476-5587
Mailing Address - Fax:
Practice Address - Street 1:5653 S. WILMER TERR
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34448
Practice Address - Country:US
Practice Address - Phone:352-476-5587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No344600000XTransportation ServicesTaxi