Provider Demographics
NPI:1639276090
Name:METRO MEDIC AMBULANCE, INC.
Entity Type:Organization
Organization Name:METRO MEDIC AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:COLON
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-768-2400
Mailing Address - Street 1:PMB47 P.O. BOX 6022
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-6022
Mailing Address - Country:US
Mailing Address - Phone:787-768-2400
Mailing Address - Fax:787-768-1120
Practice Address - Street 1:AVE. FIDALGO DIAZ 4PN7
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-768-2400
Practice Address - Fax:787-768-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 321341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR57534Medicare ID - Type Unspecified