Healthcare Provider Details

I. General information

NPI: 1699207837
Provider Name (Legal Business Name): LIFE SUPPORT AMBULANCES SA DE CV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLVD LUIS DONALDO COLOSIO MZ6 LT5 LOC 1 SM306
CANCUN QUINTANA ROO
77560
MX

IV. Provider business mailing address

PO BOX 11577
FORT LAUDERDALE FL
33339-1577
US

V. Phone/Fax

Practice location:
  • Phone: 954-526-9751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416S0300X
TaxonomyWater Ambulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: JULIETA CAMACHO
Title or Position: MANAGER
Credential:
Phone: 954-526-9751