Healthcare Provider Details

I. General information

NPI: 1205771995
Provider Name (Legal Business Name): MED SQUAD TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARCELAS BELTRAN #52 PUERTO REAL
FAJARDO PR
00740
US

IV. Provider business mailing address

PO BOX 4309
PUERTO REAL PR
00740-4309
US

V. Phone/Fax

Practice location:
  • Phone: 787-401-3001
  • Fax:
Mailing address:
  • Phone: 787-401-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LYMARIE RIBOT VIDAL
Title or Position: PRESIDENT
Credential:
Phone: 787-593-6000