Provider Demographics
NPI:1710470687
Name:ELITE TRANSPORT SOUTH, LLC
Entity Type:Organization
Organization Name:ELITE TRANSPORT SOUTH, LLC
Other - Org Name:ELITE TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ATELUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-902-9848
Mailing Address - Street 1:707 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5611
Mailing Address - Country:US
Mailing Address - Phone:305-902-9848
Mailing Address - Fax:678-402-7081
Practice Address - Street 1:707 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5611
Practice Address - Country:US
Practice Address - Phone:305-902-9848
Practice Address - Fax:678-402-7081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker