Organization
ISLA AZUL SENIOR TRANSPORT CORP
Active
Organization
ISLA AZUL SENIOR TRANSPORT CORP
Active
Other names
NEMT(Non Emergency Medical Transport)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUILLERMO GONZALEZ SR. CORP (OWNER)
(305) 680-6865
Entity
Organization
Contact information
Practice address
1037 NE PINE ISLAND LN, CAPE CORAL, FL 33909-2176
(305) 680-6865
Mailing address
1037 NE PINE ISLAND LN, CAPE CORAL, FL 33909-2176
(305) 680-6865
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780293068
—
FL
Enumeration date
08/21/2020
Last updated
08/21/2020
Update your record
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