Organization
EAFR GALLO ENTERPRISE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN ANTONIO FUENTES (CEO)
(512) 577-5825
Entity
Organization
Contact information
Practice address
5345 SE 103RD ST, BELLEVIEW, FL 34420-3291
(512) 577-5825
Mailing address
3001 SW COLLEGE ROAD, PMB 201, OCALA, FL 34474
(512) 577-5825
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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