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General NPI Number Information
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NPI Number | 1629672506
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Entity Type | Organization
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Legal Business Name | JD AMBULANCE CORPORATION
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | BO. COTTO QUEBRADAS CARR. 132 KM 9.6 INT.
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City | PENUELAS
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State | PR
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Zip | 00624-0062
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Country | US
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Telephone | 939-639-0754
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 7424
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City | PENUELAS
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State | PR
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Zip | 00624-9863
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Country | US
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Telephone | 939-639-0754
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOEL DIAZ
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Credential |
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Telephone | 939-639-0754
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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 |
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License Number State |
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