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General NPI Number Information
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NPI Number | 1992437289
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Entity Type | Organization
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Legal Business Name | EXECUTIVE MEDICAL SERVICE LLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | URB LAS COLINAS 5 CALLE 1
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-233-1703
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721
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City | VEGA ALTA
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State | PR
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Zip | 00692-0721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICARDO MELENDEZ
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Credential |
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Telephone | 787-233-1703
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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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