Provider Demographics
NPI:1558464529
Name:ADVANCED PATIENT TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:ADVANCED PATIENT TRANSPORTATION, INC.
Other - Org Name:ST. VINCENT'S AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-308-1290
Mailing Address - Street 1:2300 PARK AVENUE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073
Mailing Address - Country:US
Mailing Address - Phone:904-278-4274
Mailing Address - Fax:904-399-5919
Practice Address - Street 1:2300 PARK AVENUE
Practice Address - Street 2:SUITE 206
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073
Practice Address - Country:US
Practice Address - Phone:904-278-4274
Practice Address - Fax:904-399-5919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLALS2406341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA0644OtherBLUE CROSS
FL400078100Medicaid
FL400078100Medicaid