Provider Demographics
NPI:1609649854
Name:DIAZ MEDICAL SERVICE LCC
Entity Type:Organization
Organization Name:DIAZ MEDICAL SERVICE LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:LEONOR
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-908-0261
Mailing Address - Street 1:200 BLVD DAVID CORDOVA TORRECH APT 249
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-9998
Mailing Address - Country:US
Mailing Address - Phone:787-908-0261
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO LAGO VISTA II
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-9998
Practice Address - Country:US
Practice Address - Phone:787-908-0261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR518106OtherREGISTRO DEPARTAMENTO DE ESTADO DE PUERTO RICO