Organization
EASTERN SOURCE SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA E ROSABAL PADRON (PRESIDENT/CEO)
(239) 202-2160
Entity
Organization
Contact information
Practice address
10471 6 MILE CYPRESS PKWY STE 400, FORT MYERS, FL 33966-6973
(239) 202-2160
Mailing address
10471 6 MILE CYPRESS PKWY STE 400, FORT MYERS, FL 33966-6973
(239) 202-2160
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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