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General NPI Number Information
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NPI Number | 1154618304
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Entity Type | Organization
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Legal Business Name | JENSEN J FELICIANO-MUNIZ
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | HC 1 BOX 6670 CARR 110 KM 5 HM 4
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City | MOCA
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State | PR
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Zip | 00676-9529
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Country | US
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Telephone | 787-669-0374
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 6670 CARR 110 KM 5 HM 4
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City | MOCA
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State | PR
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Zip | 00676-9529
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Country | US
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Telephone | 787-669-0374
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENSEN J FELICIANO-MUNIZ
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Credential |
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Telephone | 787-669-0374
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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 | TCAMB 675
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License Number State | PR
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