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General NPI Number Information
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NPI Number | 1861421661
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Entity Type | Organization
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Legal Business Name | AMBULANCIAS EMERGENCIAS DEL SUR
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3069 CRUZ ST. ELGICA
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City | PONCE
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State | PR
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Zip | 00717-3069
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Country | US
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Telephone | 787-843-6985
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Fax | 787-290-4003
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Provider Business Mailing Address
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Address Line | PO BOX 692
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City | MERCEDITA
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State | PR
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Zip | 00715-0692
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Country | US
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Telephone | 787-843-6985
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Fax | 787-290-4003
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Authorized Official
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Title or Position | PRESIDENTE
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Name | JORGE LUIS SALIVA MANTILLA
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Credential | EMT
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Telephone | 787-843-6985
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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 | TC AMB 110
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License Number State | PR
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