Provider Demographics
NPI:1568544419
Name:DE JESUS AMBULANCE SERVICES
Entity Type:Organization
Organization Name:DE JESUS AMBULANCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR JUDICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSADO APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-828-2035
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664-0591
Mailing Address - Country:US
Mailing Address - Phone:787-828-2035
Mailing Address - Fax:787-828-6586
Practice Address - Street 1:CARR 144 KM 2.8
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664
Practice Address - Country:US
Practice Address - Phone:787-828-2035
Practice Address - Fax:787-828-6586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059050Medicare PIN