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General NPI Number Information
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NPI Number | 1356366942
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Entity Type | Organization
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Legal Business Name | SANTIAGO AMBULANCE INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/07/2008
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Provider Practice Location Address
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Address Line | BO. JACAGUAS SECTOR OLLA HONDA C/3 # A-5
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-2594
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Fax | 787-837-2594
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Provider Business Mailing Address
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Address Line | PO BOX 590
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-2594
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Fax | 787-837-2594
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Authorized Official
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Title or Position | OWNER
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Name | MR. LUIS G SANTIAGO JR.
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Credential |
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Telephone | 787-837-2594
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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 519
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License Number State | PR
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