Healthcare Provider Details

I. General information

NPI: 1508344136
Provider Name (Legal Business Name): PUERTO RICO MEDICAL TRANSPORT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 CALLE BORIS EDIF LA ELECTRONICA OFIC 222
SAN JUAN PR
00927
US

IV. Provider business mailing address

PO BOX 3978
GUAYNABO PR
00970-3978
US

V. Phone/Fax

Practice location:
  • Phone: 787-549-5000
  • Fax:
Mailing address:
  • Phone: 787-549-5000
  • Fax: 787-705-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: WILFREDO RODRIGUEZ
Title or Position: VICEPRESIDENT
Credential:
Phone: 787-462-8111