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General NPI Number Information
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NPI Number | 1376738914
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Entity Type | Organization
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Legal Business Name | LIFE LINK AMBULANCE CORP
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | J13 CALLE 2 URB. BRISAS DEL MAR
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City | LUQUILLO
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State | PR
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Zip | 00773-2458
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Country | US
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Telephone | 787-366-7577
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31003
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City | SAN JUAN
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State | PR
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Zip | 00929-2003
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Country | US
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Telephone | 787-366-7577
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WANDA SANTIAGO
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Credential |
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Telephone | 787-366-7577
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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-492
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License Number State | PR
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