Provider Demographics
NPI:1164036992
Name:HURRICANE TRANSPORT LLC
Entity Type:Organization
Organization Name:HURRICANE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OTTO
Authorized Official - Middle Name:R
Authorized Official - Last Name:GORDILLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:352-286-9138
Mailing Address - Street 1:16362 SW 27TH TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-7431
Mailing Address - Country:US
Mailing Address - Phone:352-286-9138
Mailing Address - Fax:
Practice Address - Street 1:16362 SW 27TH TERRACE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-7431
Practice Address - Country:US
Practice Address - Phone:352-286-9138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL19000176221OtherLLC DOCUMENT NUMBER