Healthcare Provider Details

I. General information

NPI: 1831338920
Provider Name (Legal Business Name): JES MAR AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2009
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 853 KM 13.6 BO CEDRO
CAROLINA PR
00987
US

IV. Provider business mailing address

HC 3 BOX 12080
CAROLINA PR
00987
US

V. Phone/Fax

Practice location:
  • Phone: 787-486-9604
  • Fax:
Mailing address:
  • Phone: 787-486-9604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StatePR

VIII. Authorized Official

Name: MISS MARA ANGELY CARRASQUILLO
Title or Position: PRESIDENTA
Credential:
Phone: 787-627-7657