Healthcare Provider Details

I. General information

NPI: 1285496133
Provider Name (Legal Business Name): EMS MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/26/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. ONEILL CALLE C 51
MANATI PR
00674
US

IV. Provider business mailing address

URB. ONEILL CALLE C 51
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 939-225-6836
  • Fax:
Mailing address:
  • Phone: 939-225-6836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MAX K NEGRON-DOMINGUEZ
Title or Position: OWNER
Credential:
Phone: 939-225-6836