Healthcare Provider Details

I. General information

NPI: 1073970976
Provider Name (Legal Business Name): MEDEVAC AVIATION COSTA RICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2016
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6703 NW 7TH ST SJO 927
MIAMI FL
33126-6070
US

IV. Provider business mailing address

6703 NW 7TH ST SJO 927
MIAMI FL
33126-6070
US

V. Phone/Fax

Practice location:
  • Phone: 877-208-4294
  • Fax:
Mailing address:
  • Phone: 877-208-4294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JESUS VALDEZ
Title or Position: CEO
Credential:
Phone: 619-306-7494