Provider Demographics
NPI:1487285581
Name:EVENTURA LLC
Entity type:Organization
Organization Name:EVENTURA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAIZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ-SUBERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-414-9161
Mailing Address - Street 1:10100 TAWNY MEADOW ALY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4474
Mailing Address - Country:US
Mailing Address - Phone:305-414-9161
Mailing Address - Fax:
Practice Address - Street 1:10100 TAWNY MEADOW ALY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4474
Practice Address - Country:US
Practice Address - Phone:305-414-9161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)