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General NPI Number Information
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NPI Number | 1992784920
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Entity Type | Individual
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Provider Name | BENJAMIN STIXRUD HS, AMS, NREMT
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 260 GUARD RD
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City | AGUADILLA
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State | PR
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Zip | 00603-1304
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Country | US
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Telephone | 787-890-8477
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Fax |
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Provider Business Mailing Address
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Address Line | 260 GUARD RD
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City | AGUADILLA
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State | PR
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Zip | 00603-1304
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 02182001
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | B1391377
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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