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General NPI Number Information
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NPI Number | 1982785499
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Entity Type | Organization
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Legal Business Name | ST. PETER AMBULANCE
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | CARR 184 KM 0.8 BO. CACAO BAJO
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City | PATILLAS
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State | PR
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Zip | 00723
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Country | US
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Telephone | 787-839-4050
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Fax | 787-839-4074
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Provider Business Mailing Address
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Address Line | PO BOX 1210
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City | ARROYO
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State | PR
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Zip | 00714-1210
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Country | US
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Telephone | 787-839-4050
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Fax | 787-839-4074
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAIME JORGE FLORES
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Credential | M.D.
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Telephone | 787-839-4050
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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 | TCAMB-332
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License Number State | PR
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