Provider Demographics
NPI:1891916052
Name:RAFAEL PEREZ MOLINA
Entity Type:Organization
Organization Name:RAFAEL PEREZ MOLINA
Other - Org Name:ANGEL LIFE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-820-7500
Mailing Address - Street 1:PO BOX 951
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0951
Mailing Address - Country:US
Mailing Address - Phone:787-820-7500
Mailing Address - Fax:787-820-7500
Practice Address - Street 1:CARR NUM 2 KM 84.7 BO CARRIZALES
Practice Address - Street 2:URB ALTURAS CALLE JARDIN SUITE 3
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-0000
Practice Address - Country:US
Practice Address - Phone:787-820-7500
Practice Address - Fax:787-820-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB 4063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR57983ANOtherSSS REFORMA
PR991627OtherPMC
PR991627OtherPMC