1639276090 NPI number — METRO MEDIC AMBULANCE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639276090 NPI number — METRO MEDIC AMBULANCE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METRO MEDIC AMBULANCE, 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:
1639276090
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PMB47 P.O. BOX 6022
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-6022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-768-2400
Provider Business Mailing Address Fax Number:
787-768-1120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE. FIDALGO DIAZ 4PN7
Provider Second Line Business Practice Location Address:
VILLA FONTANA
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-768-2400
Provider Business Practice Location Address Fax Number:
787-768-1120
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
RAUL
Authorized Official Middle Name:
COLON
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-768-2400

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  TC AMB 321 , 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)





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