Provider Demographics
NPI:1912754128
Name:AV DIAMOND TRANSPORTATION LLC
Entity type:Organization
Organization Name:AV DIAMOND TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADALBERTO
Authorized Official - Middle Name:E
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-300-6388
Mailing Address - Street 1:3549 RECKER HWY
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1959
Mailing Address - Country:US
Mailing Address - Phone:718-300-6388
Mailing Address - Fax:
Practice Address - Street 1:3549 RECKER HWY
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-1959
Practice Address - Country:US
Practice Address - Phone:718-300-6388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi