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
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