Provider Demographics
NPI:1801018056
Name:VERONICA IRIZARRY RODRIGUEZ
Entity Type:Organization
Organization Name:VERONICA IRIZARRY RODRIGUEZ
Other - Org Name:VERONICA MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-818-0033
Mailing Address - Street 1:PO BOX 4003
Mailing Address - Street 2:PMB 129
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-8009
Mailing Address - Country:US
Mailing Address - Phone:787-818-0033
Mailing Address - Fax:
Practice Address - Street 1:CALLE MONSENOR TORRES
Practice Address - Street 2:OFICINA # 2
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 3933416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRTC AMB 393OtherAMBULANCE LAND