Provider Demographics
NPI:1578837936
Name:SUPERIOR EMERGENCY CARE,CORP.
Entity Type:Organization
Organization Name:SUPERIOR EMERGENCY CARE,CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:O
Authorized Official - Last Name:ORTIZ GONZALEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-560-4206
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0190
Mailing Address - Country:US
Mailing Address - Phone:787-560-4206
Mailing Address - Fax:
Practice Address - Street 1:KM 0.3 CARR 109 INT 497
Practice Address - Street 2:BO POZAS
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-297-8904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB6953416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport