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General NPI Number Information
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NPI Number | 1205108081
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Entity Type | Organization
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Legal Business Name | HUMACAO CRITICAL CARE INC
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | URB VILLA ORIENTE CALLE A NUM 47
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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 | 787-514-8125
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Fax |
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Provider Business Mailing Address
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Address Line | URB VILLA ORIENTE CALLE A NUM 47
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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 | 787-514-8125
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIGUEL A CARDONA
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Credential |
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Telephone | 787-514-8125
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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 686
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License Number State | PR
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