Healthcare Provider Details

I. General information

NPI: 1639827108
Provider Name (Legal Business Name): ERA TRANSPORT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOS EUCALIPTOS SHUTE DRIVE 17107
CANOVANAS PR
00729
US

IV. Provider business mailing address

LOS EUCALIPTOS SHUTE DRIVE 17107
CANOVANAS PR
00729
US

V. Phone/Fax

Practice location:
  • Phone: 787-633-7876
  • Fax:
Mailing address:
  • Phone: 787-633-7876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: ERIC SOTO
Title or Position: OWNER
Credential:
Phone: 787-633-7876