Healthcare Provider Details

I. General information

NPI: 1629839352
Provider Name (Legal Business Name): UNITED EMS MAYAGUEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 01/19/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CERRO GORDO KM 1.9 CARR 840
BAYAMON PR
00956
US

IV. Provider business mailing address

CERRO GORDO KM 1.9 CARR 840
BAYAMON PR
00956
US

V. Phone/Fax

Practice location:
  • Phone: 787-536-8909
  • Fax: 787-777-1577
Mailing address:
  • Phone: 787-241-6590
  • Fax: 787-777-1577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: JARRELYS COLON MATOS
Title or Position: PRESIDENTE
Credential:
Phone: 787-536-8909