Healthcare Provider Details

I. General information

NPI: 1033471396
Provider Name (Legal Business Name): EL VALENCIANO AMBULANCE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO. GURABO ABAJO SECTOR PLACITA
JUNCOS PR
00777
US

IV. Provider business mailing address

PO BOX 2174
JUNCOS PR
00777-2174
US

V. Phone/Fax

Practice location:
  • Phone: 787-568-4079
  • Fax: 787-369-7990
Mailing address:
  • Phone: 787-568-4079
  • Fax: 787-369-7990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number905004
License Number StatePR

VIII. Authorized Official

Name: ALEXANDER JIMENEZ MARTINEZ
Title or Position: OWNER
Credential:
Phone: 787-568-4079