Provider Demographics
NPI:1598023038
Name:SEAGUARDIANS
Entity Type:Organization
Organization Name:SEAGUARDIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRECIDENTE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEVARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-612-0109
Mailing Address - Street 1:URB BRISAS DEL MAR
Mailing Address - Street 2:CALLE P 19
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773
Mailing Address - Country:US
Mailing Address - Phone:787-612-0109
Mailing Address - Fax:
Practice Address - Street 1:BRISAS DEL MAR
Practice Address - Street 2:STREET 19 P
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773
Practice Address - Country:US
Practice Address - Phone:787-612-0109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport