Provider Demographics
NPI:1467893529
Name:A G R LIFE TEAM LLC
Entity Type:Organization
Organization Name:A G R LIFE TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-248-7511
Mailing Address - Street 1:1040 CALLE ARCADA HACIENDA SAN JOSE
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-0000
Mailing Address - Country:US
Mailing Address - Phone:787-248-0081
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 198 KM 22 HEC 0
Practice Address - Street 2:BO MONTONES 1
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-0000
Practice Address - Country:US
Practice Address - Phone:787-248-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport