MEDICARE: FIVE STARS AMBULANCES SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance		PR

General Provider Information

NPI Number	:	1063708071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIVE STARS AMBULANCES SERVICES INC

Provider Business Mailing Address
First Line	:	L9 CALLE 17
Second Line	:	URBANIZACION LAS LEANDRAS
City	:	HUMACAO
State	:	PR
Zip	:	00791-3000
Country	:	US
Telephone Number	:	787-509-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	L9 CALLE 17
Second Line	:	URBANIZACION LAS LEANDRAS
City	:	HUMACAO
State	:	PR
Zip	:	00791-3000
Country	:	US
Telephone Number	:	787-509-4600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEAN J COLON
Credential	:
Telephone Number	:	787-509-4600

Provider Enumeration Date	:	06/28/2011
Last Update Date	:	06/28/2011

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