Provider Demographics
NPI:1821369257
Name:MEDICA MOVIL DE PUERTO RICO INC.
Entity Type:Organization
Organization Name:MEDICA MOVIL DE PUERTO RICO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-868-3171
Mailing Address - Street 1:PO BOX 1806
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-1806
Mailing Address - Country:US
Mailing Address - Phone:787-868-3171
Mailing Address - Fax:
Practice Address - Street 1:CARR.441 KM 0.6 BO. GUANIQUILLA
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-9742
Practice Address - Country:US
Practice Address - Phone:787-868-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC-AMB-6973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRTC-AMB-697OtherCSP OF PUERTO RICO LICENSE