Provider Demographics
NPI:1851022412
Name:MIA TRANSPORT LLC
Entity Type:Organization
Organization Name:MIA TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETARIO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-475-7723
Mailing Address - Street 1:URB LOMAS VERDES CALLE SALVIA 4K4
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:939-475-7723
Mailing Address - Fax:
Practice Address - Street 1:URB SANTA JUANITA CALLE 24 AU-13
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:939-475-7723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)