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General NPI Number Information
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NPI Number | 1760646590
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Entity Type | Organization
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Legal Business Name | INFINITY LIFE AMBULANCE INC
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | CALLED 12 #207 URB VEREDA
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City | JURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-649-0222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5193
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City | CAGUAS
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State | PR
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Zip | 00726-5193
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Country | US
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Telephone | 787-649-0222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NEFTALY SANTANA
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Credential | 166793
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Telephone | 787-679-0222
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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 | 166793
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License Number State | PR
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