Provider Demographics
NPI:1336603398
Name:GO SENIOR TRANSIT, LLC
Entity Type:Organization
Organization Name:GO SENIOR TRANSIT, LLC
Other - Org Name:VENEL SIMON
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VENEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-419-8708
Mailing Address - Street 1:257 S CYPRESS RD APT 418
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7032
Mailing Address - Country:US
Mailing Address - Phone:954-419-8708
Mailing Address - Fax:
Practice Address - Street 1:257 S CYPRESS RD APT 418
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-7032
Practice Address - Country:US
Practice Address - Phone:561-305-1567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GO SENIOR TRANSIT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-24
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCNA305408OtherFLORIDA BOARD OF NURSING
FLAHCA235799OtherFLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION