Provider Demographics
NPI:1891573127
Name:ELITE PASSENGER TRANSPORT LLC
Entity Type:Organization
Organization Name:ELITE PASSENGER TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ VENEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-336-9912
Mailing Address - Street 1:3502 10TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5111
Mailing Address - Country:US
Mailing Address - Phone:239-336-9912
Mailing Address - Fax:
Practice Address - Street 1:3502 10TH AVE NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-5111
Practice Address - Country:US
Practice Address - Phone:239-336-9912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)