Provider Demographics
NPI:1376551846
Name:JOSE E MONTALVO
Entity Type:Organization
Organization Name:JOSE E MONTALVO
Other - Org Name:PROCARE EMERGENCY MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:MONTALVO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:787-831-2028
Mailing Address - Street 1:URB BRISAS DEL MAR
Mailing Address - Street 2:8 SAN VICENTE DE PAUL
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-831-2028
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE SAN VCTE DE PAUL
Practice Address - Street 2:BRISAS DEL MAR
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1129
Practice Address - Country:US
Practice Address - Phone:787-831-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 3713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRY48517Medicare UPIN
PR0057614Medicare ID - Type UnspecifiedMEDICARE ID NUMBER