Organization
DIVINE TRANSPORTATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RA'SEAN DEMOND DAVIS (MGR)
(318) 402-9204
Entity
Organization
Contact information
Practice address
7225 BRIDLE PATH, SAINT CLOUD, FL 34771
(318) 402-9204
Mailing address
7225 BRIDLE PATH, SAINT CLOUD, FL 34771-9575
(318) 402-9204
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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