J17 Premier Transport

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

W362-433-59-361-0 Issued in FL

Legal business name

J17 PREMIER TRANSPORT

Practice address

11231 Lake Lanier Dr
Riverview, FL 33569-2935

Phone

(727) 251-8184

NPI assigned

Jul 2, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeffrey Mark Watters

Title

President

Phone

(727) 251-8184

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1609282334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11231 LAKE LANIER DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692935",
            "telephone_number": "727-251-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11231 LAKE LANIER DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692935",
            "telephone_number": "727-251-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J17 PREMIER TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "WATTERS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-251-8184",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "FL",
            "license": "W362-433-59-361-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Private Vehicle in Riverview, FL
• Providers in Riverview, FL by specialty
• Private Vehicle in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.