Provider Demographics
NPI:1710925656
Name:VERA, NOEL E
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:E
Last Name:VERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:VERA
Other - Middle Name:
Other - Last Name:AMBULANCE SERVICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:CARR 113N BZN 6067
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:787-895-1970
Mailing Address - Fax:787-818-0429
Practice Address - Street 1:CARR #2 KM 100.0 BO COCOS
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-1740
Practice Address - Country:US
Practice Address - Phone:787-895-1970
Practice Address - Fax:787-818-0429
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB3333416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50505OtherPREFERRED MEDICARE CHOICE
PR890462OtherM.M.M.
PR890462OtherM.M.M.