Provider Demographics
NPI:1285906727
Name:CENTRAL FLORIDA REGIONAL TRANSPORTATION AUTHORITY
Entity type:Organization
Organization Name:CENTRAL FLORIDA REGIONAL TRANSPORTATION AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF PARATRANSIT OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:HEARNDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-254-6092
Mailing Address - Street 1:455 N GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1518
Mailing Address - Country:US
Mailing Address - Phone:407-254-6092
Mailing Address - Fax:407-254-6354
Practice Address - Street 1:455 N GARLAND AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1518
Practice Address - Country:US
Practice Address - Phone:407-254-6092
Practice Address - Fax:407-254-6354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL096489106Medicaid
FL001144400Medicaid
FL096489107Medicaid