Healthcare Provider Details

I. General information

NPI: 1790734705
Provider Name (Legal Business Name): RAQUEL ESPINOSA BARAJAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 08/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 100 LOCAL A 3
CABO ROJO PR
00623-4730
US

IV. Provider business mailing address

PO BOX 7147
MAYAGUEZ PR
00681-7147
US

V. Phone/Fax

Practice location:
  • Phone: 787-254-2270
  • Fax: 787-254-2270
Mailing address:
  • Phone: 787-254-2270
  • Fax: 787-254-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberTCAMB 354
License Number StatePR

VIII. Authorized Official

Name: MRS. RAQUEL ESPINOSA
Title or Position: PRESIDENT
Credential:
Phone: 787-254-2270