Healthcare Provider Details

I. General information

NPI: 1730422841
Provider Name (Legal Business Name): GO TRANSMED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB SANTA CRUZ CALLE SANTA CRUZ B10
BAYAMON PR
00959
US

IV. Provider business mailing address

PO BOX 36265
BAYAMON PR
00936
US

V. Phone/Fax

Practice location:
  • Phone: 787-363-4353
  • Fax: 787-798-6865
Mailing address:
  • Phone: 787-363-4353
  • Fax: 787-798-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: DR. PABLO R BISONO SR.
Title or Position: PRESIDENT
Credential: MD
Phone: 787-363-4353