Provider Demographics
NPI:1851335079
Name:GOOD LUCK AMBULANCE
Entity Type:Organization
Organization Name:GOOD LUCK AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DUEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:L
Authorized Official - Last Name:FERRER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-776-8108
Mailing Address - Street 1:PO BOX 4193
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-4193
Mailing Address - Country:US
Mailing Address - Phone:787-776-8108
Mailing Address - Fax:787-276-9231
Practice Address - Street 1:C/12 BLOQ 8 #4
Practice Address - Street 2:SABANA GARDENS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-776-8108
Practice Address - Fax:787-276-9231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC-AMB-1433416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059292Medicare ID - Type Unspecified