Healthcare Provider Details

I. General information

NPI: 1891716957
Provider Name (Legal Business Name): XTREME MEDICAL CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE MONACO # 621 C EXT EL COMANDATE
CAROLINA PR
00985
US

IV. Provider business mailing address

PO BOX 1541
CAROLINA PR
00984-1541
US

V. Phone/Fax

Practice location:
  • Phone: 787-776-9306
  • Fax: 787-776-9306
Mailing address:
  • Phone: 787-776-9306
  • Fax: 787-776-9306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberTCAMB373
License Number StatePR

VIII. Authorized Official

Name: CARLOS A MALDONADO
Title or Position: PRESIDENT
Credential:
Phone: 787-776-9306