Provider Demographics
NPI:1295307577
Name:KESELL EXPRESS LLC
Entity type:Organization
Organization Name:KESELL EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:NOVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-465-9311
Mailing Address - Street 1:4990 SW 72ND AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5524
Mailing Address - Country:US
Mailing Address - Phone:561-465-9311
Mailing Address - Fax:786-294-0761
Practice Address - Street 1:106 PROVINCE DR APT C
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-4366
Practice Address - Country:US
Practice Address - Phone:561-465-9311
Practice Address - Fax:786-294-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)