Eastern Source Solutions LLC

Primary specialty

Transportation BrokerTaxonomy code 347E00000X

Legal business name

EASTERN SOURCE SOLUTIONS LLC

Practice address

10471 6 Mile Cypress Pkwy Ste 400
Fort Myers, FL 33966-6973

Phone

(239) 202-2160

NPI assigned

Oct 21, 2019

Organization subpart

No

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

Authorized official

Name

Maria E Rosabal Padron

Title

President/Ceo

Phone

(239) 202-2160

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1972146124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10471 6 MILE CYPRESS PKWY STE 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666973",
            "telephone_number": "239-202-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10471 6 MILE CYPRESS PKWY STE 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666973",
            "telephone_number": "239-202-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SOURCE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "ROSABAL PADRON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "239-202-2160"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.