Healthcare Provider Details

I. General information

NPI: 1164396792
Provider Name (Legal Business Name): FRANCISCO ARGELIS HEREDIA DE LOS SANTOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 TRIPPS LN
RIVERSIDE RI
02915-3014
US

IV. Provider business mailing address

83 ROUNDS AVE APT 2
PROVIDENCE RI
02907-3572
US

V. Phone/Fax

Practice location:
  • Phone: 401-499-3778
  • Fax:
Mailing address:
  • Phone: 401-499-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number3297970
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number3297970
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number3297970
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: