Provider Demographics
NPI:1588088371
Name:FLORIDA MEDTRANS NETWORK LLC
Entity type:Organization
Organization Name:FLORIDA MEDTRANS NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP, MANAGED CARE & PAYER RELATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WINAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-807-9324
Mailing Address - Street 1:992 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-7204
Mailing Address - Country:US
Mailing Address - Phone:631-389-2098
Mailing Address - Fax:
Practice Address - Street 1:14561 58TH ST N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-2834
Practice Address - Country:US
Practice Address - Phone:727-581-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker