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General NPI Number Information
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NPI Number | 1902112121
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Entity Type | Organization
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Legal Business Name | BRAVO AMBULANCE SERVICE LLC
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 1224 PASEO DE NEVA
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City | LAREDO
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State | TX
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Zip | 78046-7600
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Country | US
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Telephone | 956-728-7777
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Fax | 956-728-7788
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Provider Business Mailing Address
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Address Line | 1777 PATRICIA LN
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City | LAREDO
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State | TX
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Zip | 78046-7898
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Country | US
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Telephone | 956-728-7777
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Fax | 956-728-7788
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Authorized Official
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Title or Position | SECRETARY
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Name | MISS TOMASITA PEREZ
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Credential |
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Telephone | 956-753-2347
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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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