Healthcare Provider Details

I. General information

NPI: 1689064883
Provider Name (Legal Business Name): FIRST TRANSPORT MEDICAL, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NO. 10 EXT. LAS GUABAS,
CIALES PR
00683
US

IV. Provider business mailing address

10 BDA LAS GUABAS
CIALES PR
00638-3316
US

V. Phone/Fax

Practice location:
  • Phone: 787-962-8177
  • Fax:
Mailing address:
  • Phone: 787-962-8177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StatePR

VIII. Authorized Official

Name: MR. EMMANUEL MORALES
Title or Position: PRESIDENTE
Credential:
Phone: 787-962-8177