Provider Demographics
NPI:1851871032
Name:GOLDENAGETRANSPORTATIONSERVICES, CORP.
Entity Type:Organization
Organization Name:GOLDENAGETRANSPORTATIONSERVICES, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-771-6900
Mailing Address - Street 1:1404 AVE PAZ GRANELA
Mailing Address - Street 2:PMB 510 SUITE 2
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4131
Mailing Address - Country:US
Mailing Address - Phone:787-449-3784
Mailing Address - Fax:
Practice Address - Street 1:CARR 199 EDIF ALB PLAZA SUITE 16
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-282-6200
Practice Address - Fax:787-282-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC-AMB7553416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport