Healthcare Provider Details

I. General information

NPI: 1588613350
Provider Name (Legal Business Name): LEE AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE MATIAS BRUGMA 47
LAS MARIAS PR
00670
US

IV. Provider business mailing address

PO BOX 3223
LAJAS PR
00667-3223
US

V. Phone/Fax

Practice location:
  • Phone: 787-458-7160
  • Fax:
Mailing address:
  • Phone: 787-458-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTC AMB 322
License Number StatePR

VIII. Authorized Official

Name: SAMUEL CRUZ
Title or Position: PRESIDENT
Credential:
Phone: 787-458-7160