Healthcare Provider Details

I. General information

NPI: 1851615488
Provider Name (Legal Business Name): GOBIERNO MUNICIPAL GURABO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 189 KILOMETRO 2.3
GURABO PR
00778
US

IV. Provider business mailing address

PO BOX 3020
GURABO PR
00778-3020
US

V. Phone/Fax

Practice location:
  • Phone: 787-408-8888
  • Fax: 787-369-7990
Mailing address:
  • Phone: 787-408-8888
  • Fax: 787-369-7990

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. VICTOR ORTIZ DIAZ
Title or Position: ALCALDE
Credential:
Phone: 787-712-1100