Provider Demographics
NPI:1710975131
Name:B M PROFESSIONAL CARE AMBULANCE
Entity Type:Organization
Organization Name:B M PROFESSIONAL CARE AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:MALDONADO
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-276-6565
Mailing Address - Street 1:PO BOX 6017
Mailing Address - Street 2:PMB 596
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-6017
Mailing Address - Country:US
Mailing Address - Phone:787-276-6565
Mailing Address - Fax:787-701-1728
Practice Address - Street 1:CARRETERA 848KM
Practice Address - Street 2:2.8 SAINT JUST
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-276-6565
Practice Address - Fax:787-701-1728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
5 7009BMOtherS S S
890407OtherM M M
9004491OtherACCA
9870020OtherHUMANA
5 7009BMOtherS S S
=========OtherMCS
0057009Medicare ID - Type Unspecified