=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942347620
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMERIO AMBULANCE SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CALLE 30 AL 25 4TA SECCION SANTA JUANITA
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-780-8220
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 4265
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00958-1265
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-780-8220
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ANGEL M SANTIAGO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-780-8220
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | TCAMB-52
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------