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General NPI Number Information
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NPI Number | 1023659075
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Entity Type | Individual
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Provider Name | LUIS CORTES ROSALES
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Gender | Male
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 436 PLANTERS WAY
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-9070
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Country | US
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Telephone | 704-898-3368
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Fax |
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Provider Business Mailing Address
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Address Line | 436 PLANTERS WAY
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-9070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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