Healthcare Provider Details

I. General information

NPI: 1376210641
Provider Name (Legal Business Name): PROCARE MEDICAL TRANSPORT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB VILLA BARCELONA CALLE 2 F8
BARCELONETA PR
00617
US

IV. Provider business mailing address

BDA LA PRA 9
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-486-9360
  • Fax:
Mailing address:
  • Phone: 787-486-9360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: ELIAS LAUREANO RIVERA
Title or Position: PRESIDENT
Credential:
Phone: 787-486-9360