Provider Demographics
NPI:1356463293
Name:LEDUC, JOSE ANGEL (TEM PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ANGEL
Last Name:LEDUC
Suffix:
Gender:M
Credentials:TEM PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-0604
Mailing Address - Country:US
Mailing Address - Phone:787-547-1203
Mailing Address - Fax:
Practice Address - Street 1:103 CALLE 2
Practice Address - Street 2:URB PH HERNANDEZ
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-3109
Practice Address - Country:US
Practice Address - Phone:787-547-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000922146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic