=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386451284
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MIRANDA AMBULANCE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2024
-----------------------------------------------------
Last Update Date | 01/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR. 146 KM 23.1 INTERIOR SECTOR LOS ORTEGA
-----------------------------------------------------
City | CIALES
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-618-9572
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1521
-----------------------------------------------------
City | CIALES
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00638-1521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENTE
-----------------------------------------------------
Name | HECTOR JAVIER RIVERA MIRANDA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-618-9572
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------