Provider Demographics
NPI:1821629924
Name:RAYMOND, NECIA (TRANSPORTATION)
Entity Type:Individual
Prefix:
First Name:NECIA
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:TRANSPORTATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2624 E CHELSEA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-7743
Mailing Address - Country:US
Mailing Address - Phone:813-817-3551
Mailing Address - Fax:813-415-2636
Practice Address - Street 1:2624 E CHELSEA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-7743
Practice Address - Country:US
Practice Address - Phone:813-817-3551
Practice Address - Fax:813-415-2636
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)