=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356088793
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | I HEART LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2022
-----------------------------------------------------
Last Update Date | 11/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17059 MONTGOMERY AVE
-----------------------------------------------------
City | FONTANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92336-2153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-843-6600
-----------------------------------------------------
Fax | 571-336-0950
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17059 MONTGOMERY AVE
-----------------------------------------------------
City | FONTANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92336-2153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-843-6600
-----------------------------------------------------
Fax | 571-336-0950
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. FERDINAND AGUIRRE LAURITO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-453-2704
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------