Healthcare Provider Details

I. General information

NPI: 1730326901
Provider Name (Legal Business Name): JALEEN AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2009
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 848 KM 2.3 SAINT JUST
TRUJILLO ALTO PR
00754
US

IV. Provider business mailing address

HC 20 BOX 25409
SAN LORENZO PR
00754
US

V. Phone/Fax

Practice location:
  • Phone: 787-487-9578
  • Fax:
Mailing address:
  • Phone: 787-487-9578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS JESSICA RODRIGUEZ
Title or Position: PRESIDENTA
Credential:
Phone: 787-487-9578