Healthcare Provider Details

I. General information

NPI: 1265441562
Provider Name (Legal Business Name): ATENAS AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CALLE LUIS MOLINA
BARCELONETA PR
00617-3329
US

IV. Provider business mailing address

PO BOX 39
MANATI PR
00674-0039
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-2220
  • Fax: 787-970-1786
Mailing address:
  • Phone: 787-846-2220
  • Fax: 787-970-1786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTC-AMB-338
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierTC-AMB-338
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerLICENCE PUBLIC COMMISSION

VIII. Authorized Official

Name: MR. WILBERTO COLON
Title or Position: PRESIDENT
Credential: TEMP
Phone: 787-846-2220