Provider Demographics
NPI:1346495652
Name:CITY OF FERNANDINA BEACH
Entity type:Organization
Organization Name:CITY OF FERNANDINA BEACH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY FIRE CHIEF/EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RUFINO
Authorized Official - Middle Name:
Authorized Official - Last Name:MURALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-310-3152
Mailing Address - Street 1:PO BOX 2829
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32056-2829
Mailing Address - Country:US
Mailing Address - Phone:904-310-3152
Mailing Address - Fax:904-310-3453
Practice Address - Street 1:516 S. 10TH STREET
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-3530
Practice Address - Country:US
Practice Address - Phone:904-310-3152
Practice Address - Fax:904-310-3453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00710332OtherRAILROAD MEDICARE
FLA0773OtherBCBS
FL001305000Medicaid