MEDICARE: PRO HEALTH AMBULANCE SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1053545137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO HEALTH AMBULANCE SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 7017
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-7017
Country	:	US
Telephone Number	:	787-212-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1386 AVE SAN IGNACIO
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3828
Country	:	US
Telephone Number	:	787-212-4700
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENTE
Name	:	BRENDA REYES
Credential	:
Telephone Number	:	787-212-4700

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	12/03/2021

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