Provider Demographics
NPI:1801029848
Name:BORINQUEN ROUTE AMBULANCE TRANSPORTATION
Entity Type:Organization
Organization Name:BORINQUEN ROUTE AMBULANCE TRANSPORTATION
Other - Org Name:BORINQUENROUTE AMBULANCE TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-515-0027
Mailing Address - Street 1:CARR 109 KM 2.2 BO POZO HONDO
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0610
Mailing Address - Country:US
Mailing Address - Phone:787-826-3633
Mailing Address - Fax:
Practice Address - Street 1:CARR 109 KM 2.2
Practice Address - Street 2:BO POZO HONDO
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-2057
Practice Address - Country:US
Practice Address - Phone:787-826-3633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08-2763416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport