Healthcare Provider Details

I. General information

NPI: 1366410391
Provider Name (Legal Business Name): CORREA AMBULANCE SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET-1 #35 PARCELAS CELADA
GURABO PR
00778-9707
US

IV. Provider business mailing address

HC 3 BOX 4295
GURABO PR
00778-9707
US

V. Phone/Fax

Practice location:
  • Phone: 787-737-2484
  • Fax: 787-737-5556
Mailing address:
  • Phone:
  • 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: MR. MIGUEL A. CORREA
Title or Position: PRESIDENTE
Credential: ETC.
Phone: 787-737-2484