Provider Demographics
NPI:1417228149
Name:EMERGENCIAS MEDICAS YABUCOA
Entity Type:Organization
Organization Name:EMERGENCIAS MEDICAS YABUCOA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALCALDE
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SURILLO RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-893-3000
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-0658
Mailing Address - Country:US
Mailing Address - Phone:787-893-7073
Mailing Address - Fax:787-953-0128
Practice Address - Street 1:100 CALLE SATURNINO RODRIGUEZ
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3916
Practice Address - Country:US
Practice Address - Phone:787-266-1888
Practice Address - Fax:787-266-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC-AMB688341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance