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General NPI Number Information
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NPI Number | 1316713886
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Entity Type | Organization
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Legal Business Name | MAX CARE TRANSPORT LLC
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | CALLE PRINCIPAL E8 URB. PARQUE MIRA MONTE
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 939-286-9421
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 1575 AVE MUNOZ RIVERA 364
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City | PONCE
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State | PR
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Zip | 00717-0211
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Country | US
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Telephone | 939-286-9421
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE/CEO
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Name | JOSE ANTONIO SANTIAGO SEPULVEDA
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Credential |
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Telephone | 939-286-9421
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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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