NPI 1245099324

Key facts

NPI

1245099324

Entity type

Organization (NPI type 2)

Primary specialty

Non-emergency Medical Transport (VAN) 343900000X

Practice address

2008 Palmer Rd
Davenport, FL 33837-4623

Phone

(407) 221-4584

NPI assigned

Mar 18, 2024

Organization subpart

No

Authorized official

Name

Keiana Graham

Title

Ceo

Phone

(407) 221-4584

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 18, 2024.

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1245099324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 PALMER RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338374623",
            "telephone_number": "407-221-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 PALMER RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338374623",
            "telephone_number": "407-221-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "KEIANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-221-4584"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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