Provider Demographics
NPI:1740231018
Name:A RIDE TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:A RIDE TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:FELICEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-636-3616
Mailing Address - Street 1:4300 NW 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-4439
Mailing Address - Country:US
Mailing Address - Phone:305-636-3616
Mailing Address - Fax:305-636-3799
Practice Address - Street 1:4300 NW 32ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-4439
Practice Address - Country:US
Practice Address - Phone:305-636-3616
Practice Address - Fax:305-636-3799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30253343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)