Provider Demographics
NPI:1013192152
Name:JORGE NIEVES ORTEGA DBA TRAUMA CARE UNIT AMBULANCE SERVICE
Entity Type:Organization
Organization Name:JORGE NIEVES ORTEGA DBA TRAUMA CARE UNIT AMBULANCE SERVICE
Other - Org Name:TRAUMA CARE UNIT AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:OSCAR
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:TEM
Authorized Official - Phone:787-869-0305
Mailing Address - Street 1:132 CALLE TRINITARIA
Mailing Address - Street 2:URB. JARDINES DE NARANJITO
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-4418
Mailing Address - Country:US
Mailing Address - Phone:787-869-0305
Mailing Address - Fax:787-869-0305
Practice Address - Street 1:132 CALLE TRINITARIA
Practice Address - Street 2:URB. JARDINES DE NARANJITO
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-4418
Practice Address - Country:US
Practice Address - Phone:787-869-0305
Practice Address - Fax:787-869-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB3683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport