Provider Demographics
NPI:1841029014
Name:EXCELY HEALTH MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:EXCELY HEALTH MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-692-3909
Mailing Address - Street 1:801 W STATE ROAD 436 STE 2151
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3056
Mailing Address - Country:US
Mailing Address - Phone:407-782-3804
Mailing Address - Fax:
Practice Address - Street 1:801 W STATE ROAD 436 STE 2151
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3056
Practice Address - Country:US
Practice Address - Phone:407-782-3804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)