Provider Demographics
NPI:1326840836
Name:SPARTAN RESCUE TEAM
Entity type:Organization
Organization Name:SPARTAN RESCUE TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:ELIGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-455-4441
Mailing Address - Street 1:10810 BOYETTE RD STE 1751
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-8000
Mailing Address - Country:US
Mailing Address - Phone:813-260-1023
Mailing Address - Fax:
Practice Address - Street 1:12942 TRIBUTE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7567
Practice Address - Country:US
Practice Address - Phone:813-260-1023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)