Provider Demographics
NPI:1194197673
Name:JOYFUL SERVICES OF ORLANDO FLORIDA LLC
Entity Type:Organization
Organization Name:JOYFUL SERVICES OF ORLANDO FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IMOGINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-287-3764
Mailing Address - Street 1:7413 HIGH LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8731
Mailing Address - Country:US
Mailing Address - Phone:321-287-3764
Mailing Address - Fax:
Practice Address - Street 1:7413 HIGH LAKE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-8731
Practice Address - Country:US
Practice Address - Phone:321-287-3764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)