Healthcare Provider Details
I. General information
NPI: 1831746551
Provider Name (Legal Business Name): ESPARRA AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2019
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARR 723 KM 0 HM 8
AIBONITO PR
00705
US
IV. Provider business mailing address
PO BOX 1848
AIBONITO PR
00705-1848
US
V. Phone/Fax
- Phone: 787-678-6622
- Fax:
- Phone: 787-678-6672
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSE
F
ESPARRA COLON
Title or Position: PRESIDENTE
Credential:
Phone: 787-678-6672