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General NPI Number Information
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NPI Number | 1477894681
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Entity Type | Organization
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Legal Business Name | PRESTIGE MEDICAL TRANSPORT AMBULANCE CORP
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | AVE. GUARICO CALLE JOSE ROSARIO
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-568-1525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2029
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City | VEGA BAJA
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State | PR
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Zip | 00694
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OWEN DANIEL RUIZ
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Credential |
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Telephone | 787-568-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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