Provider Demographics
NPI:1962243022
Name:ADVENT CARE TRANSPORTATION, LLC
Entity type:Organization
Organization Name:ADVENT CARE TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WIDMAAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-912-2675
Mailing Address - Street 1:6347 DELTA LEAH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-1727
Mailing Address - Country:US
Mailing Address - Phone:407-912-2675
Mailing Address - Fax:
Practice Address - Street 1:6347 DELTA LEAH DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-1727
Practice Address - Country:US
Practice Address - Phone:407-912-2675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)