Provider Demographics
NPI:1619071396
Name:CITY OF NORTH PORT
Entity Type:Organization
Organization Name:CITY OF NORTH PORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:AVERY
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-240-8150
Mailing Address - Street 1:PO BOX 917320
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891
Mailing Address - Country:US
Mailing Address - Phone:305-459-0664
Mailing Address - Fax:305-421-0928
Practice Address - Street 1:4980 CITY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286
Practice Address - Country:US
Practice Address - Phone:941-423-4353
Practice Address - Fax:941-423-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL088048500Medicaid
406590292OtherRAILROAD MEDICARE