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General NPI Number Information
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NPI Number | 1790563351
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Entity Type | Organization
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Legal Business Name | FIVE STAR CARE AMBULANCE
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | URBANIZACION RIO PIEDRAS HEIGHTS CALLE PARANA 1711
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-942-6356
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 7434
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City | AGUAS BUENAS
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State | PR
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Zip | 00703-9737
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Country | US
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Telephone | 787-942-6356
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNIER FERNANDEZ
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Credential |
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Telephone | 787-942-6356
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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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