=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427345107
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MUNICIPIO DE MARICAO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2011
-----------------------------------------------------
Last Update Date | 07/01/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARRETERA 120 KILOMETRO 2200
-----------------------------------------------------
City | MARICAO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-838-3344
-----------------------------------------------------
Fax | 787-369-7990
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 837
-----------------------------------------------------
City | MARICAO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00606-0837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-838-3344
-----------------------------------------------------
Fax | 787-369-7990
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ALCALDE
-----------------------------------------------------
Name | MR. PABLO ORTIZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-692-8261
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------