1295173243 NPI number — CORTES MEDICAL TRANSPORT INC

Table of content: (NPI 1295173243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295173243 NPI number — CORTES MEDICAL TRANSPORT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORTES MEDICAL TRANSPORT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295173243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 59 BOX 6500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00602-9667
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-315-3535
Provider Business Mailing Address Fax Number:
787-868-0348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR #2 KM 137.8 INT
Provider Second Line Business Practice Location Address:
BO. CERRO GORDO
Provider Business Practice Location Address City Name:
AGUADA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-315-3535
Provider Business Practice Location Address Fax Number:
787-868-0348
Provider Enumeration Date:
06/12/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CORTES RAMIREZ
Authorized Official First Name:
ALFREDO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-315-3535

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  TCAMB628 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TCAMB628 . This is a "STATE LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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