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General NPI Number Information
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NPI Number | 1457599110
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Entity Type | Organization
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Legal Business Name | PEDRO J NEVAREZ BRUNO
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | URB.CIBUCO CALLE 1 C-13
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City | COROZAL
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State | PR
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Zip | 00783-1341
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Country | US
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Telephone | 787-451-2727
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Fax | 787-785-6097
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Provider Business Mailing Address
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Address Line | PO BOX 3061
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City | BAYAMON
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State | PR
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Zip | 00960-3061
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Country | US
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Telephone | 787-642-6272
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Fax | 787-785-6097
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Authorized Official
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Title or Position | OWNER
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Name | PEDRO JAVIER NEVAREZ
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Credential |
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Telephone | 787-642-6272
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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-AMB575
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License Number State | PR
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