Provider Demographics
NPI:1528627114
Name:KHAKIROB INC
Entity type:Organization
Organization Name:KHAKIROB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-582-6368
Mailing Address - Street 1:1513 SE 20TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-2609
Mailing Address - Country:US
Mailing Address - Phone:305-582-6368
Mailing Address - Fax:904-369-9015
Practice Address - Street 1:1513 SE 20TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-2609
Practice Address - Country:US
Practice Address - Phone:305-582-6368
Practice Address - Fax:904-369-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL343900000XOtherNON-EMERGENCY MEDICAL TRANSPORTATION (VAN)