Provider Demographics
NPI:1568767846
Name:GUARDIAN ANGEL TRANSPORT NON EMERGENCY MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:GUARDIAN ANGEL TRANSPORT NON EMERGENCY MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-822-0081
Mailing Address - Street 1:PO BOX 4337
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33918-4337
Mailing Address - Country:US
Mailing Address - Phone:239-822-0081
Mailing Address - Fax:941-882-8267
Practice Address - Street 1:5237 SUMMERLIN COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2158
Practice Address - Country:US
Practice Address - Phone:239-822-0081
Practice Address - Fax:941-882-8267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)