Provider Demographics
NPI:1023360070
Name:JEZREELCITAS
Entity Type:Organization
Organization Name:JEZREELCITAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSVALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-370-5021
Mailing Address - Street 1:PO BOX 987
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-0987
Mailing Address - Country:US
Mailing Address - Phone:787-370-5021
Mailing Address - Fax:787-715-2221
Practice Address - Street 1:BO. FLORIDA CARRETERA 183 RAMAL 9929
Practice Address - Street 2:KM 1.6
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754-0000
Practice Address - Country:US
Practice Address - Phone:787-370-5021
Practice Address - Fax:787-715-2221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEZREEL AMBULANCE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPCVTE 4440344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi