Provider Demographics
NPI:1780457689
Name:LIFETIME TRANSPORTATION LLC
Entity type:Organization
Organization Name:LIFETIME TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-944-6060
Mailing Address - Street 1:2300 W 84TH ST STE 403A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5773
Mailing Address - Country:US
Mailing Address - Phone:786-944-6060
Mailing Address - Fax:
Practice Address - Street 1:2300 W 84TH ST STE 403A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5773
Practice Address - Country:US
Practice Address - Phone:786-944-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)