Provider Demographics
NPI:1639180979
Name:BOARD OF COUNTY COMMISSIONERS COUNTY OF MONROE
Entity Type:Organization
Organization Name:BOARD OF COUNTY COMMISSIONERS COUNTY OF MONROE
Other - Org Name:MONROE COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-289-6088
Mailing Address - Street 1:PO BOX 11713
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:490 E 63RD ST
Practice Address - Street 2:RM 170
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-4720
Practice Address - Country:US
Practice Address - Phone:305-289-6010
Practice Address - Fax:305-289-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3223341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL087736100Medicaid
FL590004509OtherRAILROAD PROVIDER ID
FL590004509OtherRAILROAD PROVIDER ID