Provider Demographics
NPI:1942306071
Name:CITY OF MAITLAND
Entity type:Organization
Organization Name:CITY OF MAITLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-539-6226
Mailing Address - Street 1:PO BOX 941086
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-1086
Mailing Address - Country:US
Mailing Address - Phone:407-539-6226
Mailing Address - Fax:407-599-0858
Practice Address - Street 1:1776 INDEPENDENCE LN
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5639
Practice Address - Country:US
Practice Address - Phone:407-539-6226
Practice Address - Fax:407-599-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3177341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL590014784OtherRAILROAD MEDICARE
FL400064100Medicaid
FLA0719Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER