Provider Demographics
NPI:1407430614
Name:DISMA TRANSPORTATION LLC
Entity Type:Organization
Organization Name:DISMA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINES
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-557-8844
Mailing Address - Street 1:7200 LAKE ELLENOR DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5786
Mailing Address - Country:US
Mailing Address - Phone:407-557-8844
Mailing Address - Fax:
Practice Address - Street 1:7200 LAKE ELLENOR DR STE 104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5786
Practice Address - Country:US
Practice Address - Phone:407-557-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DISMA POOL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-12
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)