Provider Demographics
NPI:1376851998
Name:MEDICAL TRANSPORT OF CENTRAL FLORIDA,INC.
Entity Type:Organization
Organization Name:MEDICAL TRANSPORT OF CENTRAL FLORIDA,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-314-8563
Mailing Address - Street 1:3913 KENILWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-4425
Mailing Address - Country:US
Mailing Address - Phone:863-314-8563
Mailing Address - Fax:863-314-8565
Practice Address - Street 1:3913 KENILWORTH BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-4425
Practice Address - Country:US
Practice Address - Phone:863-314-8563
Practice Address - Fax:863-314-8565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNET0003343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)