Provider Demographics
NPI:1962685370
Name:ISLOTES AMBULANCE INC
Entity Type:Organization
Organization Name:ISLOTES AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGUE CANDELARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-881-0429
Mailing Address - Street 1:PO BOX 141348
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1348
Mailing Address - Country:US
Mailing Address - Phone:787-881-0429
Mailing Address - Fax:787-818-0429
Practice Address - Street 1:BO. ISLOTES, SECTOR PIQUINA
Practice Address - Street 2:CARR 681 KM 4.3
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-881-0429
Practice Address - Fax:787-818-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 5143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059643Medicare PIN