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General NPI Number Information
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NPI Number | 1346503059
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Entity Type | Organization
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Legal Business Name | GENEIZAACK MEDICAL TRANSPORT
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | AVE FONT MARTELO #158-A
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City | HUMACAO
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State | PR
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Zip | 00791-9998
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Country | US
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Telephone | 787-719-6399
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 651
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City | HUMACAO
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State | PR
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Zip | 00792-0651
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Country | US
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Telephone | 787-719-6399
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | PEDRO MIRANDA
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Credential |
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Telephone | 787-719-6399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State | PR
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