Healthcare Provider Details

I. General information

NPI: 1972043651
Provider Name (Legal Business Name): LOGISTICS TECHNOLOGY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ISLA GRANDE AIRPORT LOT 1 NORTH RAMP
SAN JUAN PR
00907
US

IV. Provider business mailing address

PO BOX 10433
SAN JUAN PR
00922-0433
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-2222
  • Fax:
Mailing address:
  • Phone: 787-620-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberS1701CT261
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number1137TT
License Number StatePR

VIII. Authorized Official

Name: CARLOS MANUEL CARRASQUILLO
Title or Position: CO-FOUNDER
Credential:
Phone: 787-528-1573