Provider Demographics
NPI:1114103801
Name:BENJAMIN AVILES MELENDEZ
Entity Type:Organization
Organization Name:BENJAMIN AVILES MELENDEZ
Other - Org Name:B A MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:787-369-5572
Mailing Address - Street 1:HC 2 BOX 6532
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687
Mailing Address - Country:US
Mailing Address - Phone:787-369-5572
Mailing Address - Fax:
Practice Address - Street 1:CARR. 6622 KM. 7 SECTOR LA LINEA
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:787-369-5572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC-AMB 5123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport