Provider Demographics
NPI:1851950133
Name:ARIZOLA, MIGUEL ANGEL (EMT-LP)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:ANGEL
Last Name:ARIZOLA
Suffix:
Gender:M
Credentials:EMT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 MARCELLA AVE REAR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-3957
Mailing Address - Country:US
Mailing Address - Phone:956-744-5211
Mailing Address - Fax:
Practice Address - Street 1:1812 MARCELLA AVE REAR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-3957
Practice Address - Country:US
Practice Address - Phone:956-744-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)