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General NPI Number Information
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NPI Number | 1467789024
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Entity Type | Organization
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Legal Business Name | LIZZETTE LABOY
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | CARRETERA 149 KM 64.7 BO. GUAYABAL SECTOR TOCADILLO
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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 | 787-371-7277
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Fax | 787-837-8710
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Provider Business Mailing Address
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Address Line | HC 05 BOX 13364
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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 | 787-371-7277
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Fax | 787-837-8710
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Authorized Official
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Title or Position | OWNER
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Name | LIZZETTE LABOY
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Credential |
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Telephone | 787-371-7277
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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 501
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License Number State | PR
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