Provider Demographics
NPI:1114103074
Name:M & L AMBULANCE
Entity Type:Organization
Organization Name:M & L AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF THE COMPANY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS IN NURSING
Authorized Official - Phone:1787-823-2367
Mailing Address - Street 1:BO. ENSENADA, CARR. 414 KM 1.2
Mailing Address - Street 2:P.O. BOX 1269
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677
Mailing Address - Country:US
Mailing Address - Phone:787-823-2367
Mailing Address - Fax:787-823-2367
Practice Address - Street 1:BO. ENSENADA, CARR. 414 KM 1.2
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677
Practice Address - Country:US
Practice Address - Phone:787-823-2367
Practice Address - Fax:787-823-2367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR024047341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance