MEDICARE: HEART EMS

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician

General Provider Information

NPI Number	:	1467016287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART EMS

Provider Business Mailing Address
First Line	:	ANDREAS COURT
Second Line	:	370 CALLE 10 STE 10
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976
Country	:	US
Telephone Number	:	787-627-7657
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 CALLE BORI ST 202
Second Line	:	EDIFICIO LA ELECTRONICA
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0092
Country	:	US
Telephone Number	:	787-627-7657
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARANGELY CARRASQUILLO
Credential	:
Telephone Number	:	787-627-7657

Provider Enumeration Date	:	04/26/2019
Last Update Date	:	04/26/2019

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Directions to “HEART EMS ” Practice Location

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