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General NPI Number Information
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NPI Number | 1306130935
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Entity Type | Organization
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Legal Business Name | PEDIATRIC & ADULT MEDICAL SERVICE, AMBULANCE INC
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | CALLE 20 R 1 CIUDAD UNIVERSITARIA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-671-9952
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Fax | 787-762-5161
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Provider Business Mailing Address
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Address Line | PO BOX 2367
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City | CANOVANAS
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State | PR
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Zip | 00729-2367
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Country | US
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Telephone | 787-671-9952
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Fax | 787-762-5161
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MR. PEDRO JUAN MARTINEZ
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Credential | E.M.T.
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Telephone | 787-671-9952
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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 | 2579696
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License Number State | PR
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