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General NPI Number Information
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NPI Number | 1144815887
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Entity Type | Organization
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Legal Business Name | ADVANCED LIFE SYSTEM LLC
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | BO RINCON CARR 189 INT RAMAL 932 KM 3.5
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-604-6563
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 12142
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City | GURABO
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State | PR
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Zip | 00778-9633
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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 | PRESIDENTE
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Name | MICHELLE LUCIANO
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Credential |
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Telephone | 787-604-6563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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