Provider Demographics
NPI:1750300034
Name:VANGAS, CARLOS N
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:N
Last Name:VANGAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:VANGAS
Other - Middle Name:AMBULANCE
Other - Last Name:SERVICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:CARR 477 BZN 1504 LAS TALAS
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-1504
Mailing Address - Country:US
Mailing Address - Phone:787-895-1797
Mailing Address - Fax:787-818-0429
Practice Address - Street 1:CARR 477 BO CACAO SECTOR LAS TALAS
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-1797
Practice Address - Fax:787-818-0429
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 4083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0058315Medicare PIN