Provider Demographics
NPI:1255896882
Name:LOS ANGELES TRANSPORTATION CORP
Entity type:Organization
Organization Name:LOS ANGELES TRANSPORTATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARVELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-638-8615
Mailing Address - Street 1:5248 GOLDEN GATE PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-7622
Mailing Address - Country:US
Mailing Address - Phone:954-638-8615
Mailing Address - Fax:
Practice Address - Street 1:5248 GOLDEN GATE PKWY STE 600
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7622
Practice Address - Country:US
Practice Address - Phone:954-638-8615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006738600Medicaid