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General NPI Number Information
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NPI Number | 1861441610
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Entity Type | Organization
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Legal Business Name | CRISTAL AMBULANCE SYSTEM
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | URB VILLA ROSA III 8B CALLE A
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City | GUAYAMA
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State | PR
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Zip | 00784
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Country | US
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Telephone | 787-866-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 58B CALLE 4
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City | GUAYAMA
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State | PR
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Zip | 00784-6202
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Country | US
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Telephone | 787-866-7770
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDWIN LOPEZ
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Credential |
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Telephone | 787-866-7770
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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 271
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License Number State | PR
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