Healthcare Provider Details

I. General information

NPI: 1467016287
Provider Name (Legal Business Name): HEART EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 CALLE BORI ST 202 EDIFICIO LA ELECTRONICA
SAN JUAN PR
00926-0092
US

IV. Provider business mailing address

ANDREAS COURT 370 CALLE 10 STE 10
TRUJILLO ALTO PR
00976
US

V. Phone/Fax

Practice location:
  • Phone: 787-627-7657
  • Fax:
Mailing address:
  • Phone: 787-627-7657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARANGELY CARRASQUILLO
Title or Position: PRESIDENT
Credential:
Phone: 787-627-7657