Provider Demographics
NPI:1558013359
Name:NURTEC TRANSPORTATION LLC
Entity type:Organization
Organization Name:NURTEC TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-863-6762
Mailing Address - Street 1:412 E MADISON ST STE 1206
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4619
Mailing Address - Country:US
Mailing Address - Phone:813-863-6762
Mailing Address - Fax:813-354-4547
Practice Address - Street 1:412 E MADISON ST STE 1206
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4619
Practice Address - Country:US
Practice Address - Phone:813-863-6762
Practice Address - Fax:813-354-4547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-23
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684179196Medicaid