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General NPI Number Information
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NPI Number | 1164243606
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Entity Type | Organization
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Legal Business Name | I-CARE MEDICAL SERVICE LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | CARR PR-3 RAMAL 924 PARCELA 106 BO ANTON RUIZ
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-428-6339
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Fax |
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Provider Business Mailing Address
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Address Line | URBANIZACION SANTA MARIA F17 CALLE 7
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City | CEIBA
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State | PR
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Zip | 00735
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Country | US
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Telephone | 787-428-6339
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TATIANA MATTA
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Credential |
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Telephone | 787-428-6339
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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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