Provider Demographics
NPI:1073561197
Name:GILBERTO RODRGUEZ
Entity Type:Organization
Organization Name:GILBERTO RODRGUEZ
Other - Org Name:FAST HEALTH CARE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRGUEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:787-431-3774
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0946
Mailing Address - Country:US
Mailing Address - Phone:787-431-3774
Mailing Address - Fax:787-872-4822
Practice Address - Street 1:AVE. JUAN HERNNDEZ ORTIZ # 15
Practice Address - Street 2:ESQ. AGUSTN RAMOS CALERO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-431-3774
Practice Address - Fax:787-872-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB3823416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057746Medicare ID - Type UnspecifiedPROVEEDOR