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General NPI Number Information
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NPI Number | 1598713729
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Entity Type | Organization
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Legal Business Name | ENTERL LIFE AMBULANCE, CORP
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | # 76 ALTOS CALLE: GEORGETTI
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City | RIO PIEDRAS
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State | PR
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Zip | 00928
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Country | US
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Telephone | 787-753-6826
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Fax |
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Provider Business Mailing Address
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Address Line | # 76 ALTOS CALLE: GEORGETTI
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City | RIO PIEDRAS
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State | PR
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Zip | 00928
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Country | US
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Telephone | 787-753-6826
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Fax |
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Authorized Official
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Title or Position | GERENTE
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Name | MR. EFRAIN TORRES
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Credential |
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Telephone | 787-517-5858
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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 | TCAMB-350
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License Number State | PR
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