Organization
EVOLVED SOURCE SOLUTIONS CORP
Active
Organization
EVOLVED SOURCE SOLUTIONS CORP
Active
Other names
ESS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL A PUENTES (PRESIDENT)
(239) 288-9470
Entity
Organization
Contact information
Practice address
8411 HERON POND DR APT B110, LEHIGH ACRES, FL 33972-8548
(239) 288-9470
Mailing address
PO BOX 516, LEHIGH ACRES, FL 33970-0516
(239) 288-9470
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
P52-541-79-263-0
FL
343800000X
Secured Medical Transport (VAN)
P52-541-79-263-0
FL
343900000X
Non-emergency Medical Transport (VAN)
Primary
P52-541-79-263-0
FL
347C00000X
Private Vehicle
P52-541-79-263-0
FL
347E00000X
Transportation Broker
P52-541-79-263-0
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P532-541-79-263-0
FLLICENSE
FL
Enumeration date
02/02/2018
Last updated
06/16/2018
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