Provider Demographics
NPI:1790262103
Name:GO LOGIX LLC
Entity Type:Organization
Organization Name:GO LOGIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WAXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-335-2028
Mailing Address - Street 1:2406 E STATE ROAD 60 UNIT 58
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33595-8004
Mailing Address - Country:US
Mailing Address - Phone:813-335-2028
Mailing Address - Fax:
Practice Address - Street 1:911 S WOODROW WILSON ST STE 7
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-9301
Practice Address - Country:US
Practice Address - Phone:813-335-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport