Provider Demographics
NPI:1417398694
Name:ANGEL COURTESY LLC
Entity Type:Organization
Organization Name:ANGEL COURTESY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-353-2737
Mailing Address - Street 1:153 GOLF AIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-6902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:153 GOLF AIRE BLVD
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-6902
Practice Address - Country:US
Practice Address - Phone:863-353-2737
Practice Address - Fax:863-638-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X, 344600000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle