Individual provider · NPI-1

Dereisha R Cobb

Non-emergency Medical Transport (VAN) · Lehigh Acres, FL

NPI number1114692654
StatusActive
Last updated in NPPESApr 30, 2024

Details

NPI
1114692654
Entity type
Individual (NPI-1)
Name
Dereisha R Cobb
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 16, 2021
Certification date
Aug 16, 2021
Last updated
Apr 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
343900000X Non-emergency Medical Transport (VAN)–FLYes

Practice location

771 Nina Ave S
Lehigh Acres, FL 33974-5507

Phone 239-789-3545

Mailing address

771 Nina Ave S
Lehigh Acres, FL 33974-5507

Phone 239-789-3545

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