Provider Demographics
NPI:1598856262
Name:NOEL MEDINA GONZALEZ
Entity Type:Organization
Organization Name:NOEL MEDINA GONZALEZ
Other - Org Name:ARROW MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA GONZALEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-752-2463
Mailing Address - Street 1:C8 CALLE HERMOGENES FIGUEROA
Mailing Address - Street 2:URB. VILLA SAN ANTON
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-6803
Mailing Address - Country:US
Mailing Address - Phone:787-752-2463
Mailing Address - Fax:787-752-2463
Practice Address - Street 1:C8 CALLE HERMOGENES FIGUEROA
Practice Address - Street 2:URB. VILLA SAN ANTON
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-6803
Practice Address - Country:US
Practice Address - Phone:787-752-2463
Practice Address - Fax:787-752-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 1453416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059299Medicare ID - Type UnspecifiedAMBULANCE SERVICE PROVIDE