=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891678868
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ULTRA CARE EMERGENCY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 CARR 459 # KM
-----------------------------------------------------
City | AGUADILLA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00603-6200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-324-8896
-----------------------------------------------------
Fax | 787-868-0348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 8 BOX 24471
-----------------------------------------------------
City | AGUADILLA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00603-9659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-324-8896
-----------------------------------------------------
Fax | 787-868-0348
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENTE
-----------------------------------------------------
Name | JOMAR CORTES SOTO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-324-8896
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------