Provider Demographics
NPI:1063393825
Name:MJ TRANSPORTATION CARE SERVICE LLC
Entity type:Organization
Organization Name:MJ TRANSPORTATION CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMENTEL FABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-264-2409
Mailing Address - Street 1:1421 COMMERCIAL PARK DR STE 6
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-6567
Mailing Address - Country:US
Mailing Address - Phone:863-210-5966
Mailing Address - Fax:863-210-5966
Practice Address - Street 1:1421 COMMERCIAL PARK DR STE 6
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-6567
Practice Address - Country:US
Practice Address - Phone:863-210-5966
Practice Address - Fax:863-210-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)