Provider Demographics
NPI:1598279945
Name:MIGUEL A MONTALVO SR
Entity Type:Organization
Organization Name:MIGUEL A MONTALVO SR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTALVO BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-207-9801
Mailing Address - Street 1:26 CALLE CONFESOR JIMENEZ
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-1759
Mailing Address - Country:US
Mailing Address - Phone:787-207-9801
Mailing Address - Fax:787-551-7104
Practice Address - Street 1:1175 AVE EMERITO ESTRADA RIVERA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-3016
Practice Address - Country:US
Practice Address - Phone:787-207-9801
Practice Address - Fax:787-551-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4772540341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance