Healthcare Provider Details

I. General information

NPI: 1700836236
Provider Name (Legal Business Name): INTENSIVE CARE TRANSPORT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STATE ROAD # 3, KM. 2 EL TUNEL CAR CARE MALL, SUITE 23
SAN JUAN PR
00926
US

IV. Provider business mailing address

PO BOX 9022556
SAN JUAN PR
00902-2556
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-7207
  • Fax: 787-474-7214
Mailing address:
  • Phone: 787-474-7207
  • Fax: 787-474-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTC-AMB-376
License Number StatePR

VIII. Authorized Official

Name: AMAURY HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-474-7207