Provider Demographics
NPI:1053183269
Name:WHEELCHAIR OF LIFE
Entity type:Organization
Organization Name:WHEELCHAIR OF LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOYCARM
Authorized Official - Middle Name:
Authorized Official - Last Name:COTHIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-399-2868
Mailing Address - Street 1:7580 NW 5TH ST # 16958
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1607
Mailing Address - Country:US
Mailing Address - Phone:305-399-2868
Mailing Address - Fax:
Practice Address - Street 1:3750 NW 28TH ST UNIT 418
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6225
Practice Address - Country:US
Practice Address - Phone:305-399-2868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)