Provider Demographics
NPI:1609350859
Name:PALM MEDICAL TRANSPORTAION LLC
Entity Type:Organization
Organization Name:PALM MEDICAL TRANSPORTAION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-219-5886
Mailing Address - Street 1:2613 NE 41ST CIR
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5163
Mailing Address - Country:US
Mailing Address - Phone:305-219-5886
Mailing Address - Fax:
Practice Address - Street 1:2613 NE 41ST CIR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5163
Practice Address - Country:US
Practice Address - Phone:305-219-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-23
Last Update Date:2018-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)