Provider Demographics
NPI:1043061138
Name:AGOSTO MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:AGOSTO MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASISTENTE ADMINISTRATIVO
Authorized Official - Prefix:
Authorized Official - First Name:DASHIRAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGOSTO CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-612-1681
Mailing Address - Street 1:HC 23 BOX 6422
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-9798
Mailing Address - Country:US
Mailing Address - Phone:939-326-8777
Mailing Address - Fax:
Practice Address - Street 1:BO MANGO 188 CARR 31 CALLE POMARROSA
Practice Address - Street 2:KM 19.8
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-628-4863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport