Individual
FELIPE SANTELL RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2554 MIAMI ST, LAKE STATION, IN 46405-2156
(773) 791-7152
Mailing address
2554 MIAMI ST, LAKE STATION, IN 46405-2156
(773) 791-7152
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
341011963
IN
347C00000X
Private Vehicle
3410101963
IN
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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