Provider Demographics
NPI:1073970976
Name:MEDEVAC AVIATION COSTA RICA
Entity Type:Organization
Organization Name:MEDEVAC AVIATION COSTA RICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-306-7494
Mailing Address - Street 1:6703 NW 7TH ST
Mailing Address - Street 2:SJO 927
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6070
Mailing Address - Country:US
Mailing Address - Phone:877-208-4294
Mailing Address - Fax:
Practice Address - Street 1:6703 NW 7TH ST
Practice Address - Street 2:SJO 927
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-6070
Practice Address - Country:US
Practice Address - Phone:877-208-4294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport