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General NPI Number Information
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NPI Number | 1194930594
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Entity Type | Organization
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Legal Business Name | PABLO A GOMEZ CORTES
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | CARR 467, KM. 4.4 INT. BO. CAMASEYES
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 787-617-9110
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Fax | 787-818-0429
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Provider Business Mailing Address
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Address Line | 137 CALLE HARRISON
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City | AGUADILLA
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State | PR
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Zip | 00603-1503
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Country | US
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Telephone | 787-617-9110
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Fax | 787-890-0724
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Authorized Official
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Title or Position | OWNER
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Name | PABLO A GOMEZ CORTES
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Credential |
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Telephone | 787-617-9110
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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 | TC AMB 411
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License Number State | PR
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