Healthcare Provider Details

I. General information

NPI: 1053284992
Provider Name (Legal Business Name): PUERTO RICO MEDICAL TRANSPORTATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 C. JUAN PONCE DE LEON
SAN JUAN PR
00926
US

IV. Provider business mailing address

PO BOX 3910
GUAYNABO PR
00970-3910
US

V. Phone/Fax

Practice location:
  • Phone: 787-462-8111
  • Fax:
Mailing address:
  • Phone: 787-462-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. WILFREDO RODRIGUEZ-MORENO
Title or Position: PRESIDENT
Credential:
Phone: 787-462-8111