Provider Demographics
NPI:1053801431
Name:QUALITY 1 TRANSPORTATION
Entity type:Organization
Organization Name:QUALITY 1 TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:QUERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-408-3420
Mailing Address - Street 1:9712 KINGS CANYON PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1094
Mailing Address - Country:US
Mailing Address - Phone:813-408-3420
Mailing Address - Fax:
Practice Address - Street 1:9712 KINGS CANYON PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1094
Practice Address - Country:US
Practice Address - Phone:813-408-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0001Medicaid