Provider Demographics
NPI:1366476665
Name:STAT MEDICAL TRANSPORT, CORP.
Entity Type:Organization
Organization Name:STAT MEDICAL TRANSPORT, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVERIO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-675-0179
Mailing Address - Street 1:PO BOX 49001
Mailing Address - Street 2:PMB 028
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9001
Mailing Address - Country:US
Mailing Address - Phone:787-384-7329
Mailing Address - Fax:787-820-3198
Practice Address - Street 1:BO BAYANEY
Practice Address - Street 2:CARR 134 KM 21.9
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-0000
Practice Address - Country:US
Practice Address - Phone:787-384-7329
Practice Address - Fax:787-820-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB340341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR57184OtherTRIPLE S
PR890455OtherMEDICARE Y MUCHO MAS
PR=========OtherPREFERRED MEDICARE CHOICE
PR0056978Medicare ID - Type UnspecifiedAMBULANCE SERVICES