=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912702101
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAXIMD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2025
-----------------------------------------------------
Last Update Date | 02/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1225 JUAN PONCE DE LEON
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-587-5843
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 AVE WINSTON CHURCHILL STE 129
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00926-6065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-619-7699
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KARLA M FORTI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-619-7699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------