Provider Demographics
NPI:1033480330
Name:CABA MEDICAB LLC
Entity type:Organization
Organization Name:CABA MEDICAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:LUHATTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-915-7464
Mailing Address - Street 1:1412 W WATERS AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-2802
Mailing Address - Country:US
Mailing Address - Phone:813-915-7464
Mailing Address - Fax:
Practice Address - Street 1:11004 GOLDEN SILENCE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-2334
Practice Address - Country:US
Practice Address - Phone:813-915-7464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)