Healthcare Provider Details

I. General information

NPI: 1184675894
Provider Name (Legal Business Name): RODMART AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 3 SUITE 5B SIERRA BAYAMON
BAYAMON PR
00959-5183
US

IV. Provider business mailing address

225 CALLE AQUAMARINA URB PARQUE DE ISLA VERDE
CAROLINA PR
00979-1360
US

V. Phone/Fax

Practice location:
  • Phone: 787-251-4294
  • Fax:
Mailing address:
  • Phone: 787-251-4294
  • Fax: 787-785-7773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number341600000X
License Number StatePR

VIII. Authorized Official

Name: SILVIO DIEGO REYEZ SR.
Title or Position: PRESIDENT
Credential:
Phone: 787-251-4294