Provider Demographics
NPI:1467233452
Name:LEGACY CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:LEGACY CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-497-8014
Mailing Address - Street 1:2725 OSPREY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8774
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2725 OSPREY CREEK LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-8774
Practice Address - Country:US
Practice Address - Phone:407-497-8014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)