Provider Demographics
NPI:1619662921
Name:CORBELLE TRANSPORT
Entity Type:Organization
Organization Name:CORBELLE TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:LEANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-306-3507
Mailing Address - Street 1:9207 SW 147TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9207 SW 147TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4112
Practice Address - Country:US
Practice Address - Phone:786-306-3507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)