Healthcare Provider Details

I. General information

NPI: 1154652675
Provider Name (Legal Business Name): NICOLE MARIE NAPOLITANO EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CALLE LA PUNTILLA
SAN JUAN PR
00901-1818
US

IV. Provider business mailing address

5 CALLE LA PUNTILLA
SAN JUAN PR
00901-1818
US

V. Phone/Fax

Practice location:
  • Phone: 787-729-2035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number3203046589
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: