Provider Demographics
NPI:1790163939
Name:THE OPTION TRANSPORTATION CORP
Entity Type:Organization
Organization Name:THE OPTION TRANSPORTATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-661-4252
Mailing Address - Street 1:615 W 186TH ST APT 2J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2628
Mailing Address - Country:US
Mailing Address - Phone:954-661-4252
Mailing Address - Fax:
Practice Address - Street 1:5331 SW 90TH AVE
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-5112
Practice Address - Country:US
Practice Address - Phone:954-661-4252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343800000X
347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343800000XTransportation ServicesSecured Medical Transport (VAN)