Provider Demographics
NPI:1891716957
Name:XTREME MEDICAL CARE CORP
Entity Type:Organization
Organization Name:XTREME MEDICAL CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-776-9306
Mailing Address - Street 1:PO BOX 1541
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-1541
Mailing Address - Country:US
Mailing Address - Phone:787-776-9306
Mailing Address - Fax:787-776-9306
Practice Address - Street 1:CALLE MONACO
Practice Address - Street 2:# 621 C EXT EL COMANDATE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-776-9306
Practice Address - Fax:787-776-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB373341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057753Medicare ID - Type Unspecified