Healthcare Provider Details

I. General information

NPI: 1356398374
Provider Name (Legal Business Name): V.I.P. AMBULANCE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 CALLE JOSE F DIAZ APTO 1502 COND MONTE BRISAS
SAN JUAN PR
00926-5972
US

IV. Provider business mailing address

PO BOX 29004
SAN JUAN PR
00929-0004
US

V. Phone/Fax

Practice location:
  • Phone: 787-708-4558
  • Fax: 787-731-2711
Mailing address:
  • Phone: 787-708-4558
  • Fax: 787-790-9212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTCAMB313
License Number StatePR

VIII. Authorized Official

Name: WANDA SANTIAGO
Title or Position: PRESIDENTE
Credential:
Phone: 787-708-4558