Provider Demographics
NPI:1023345840
Name:MRB MEDICAL AMBULANCE SERVICES INC
Entity type:Organization
Organization Name:MRB MEDICAL AMBULANCE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-448-7383
Mailing Address - Street 1:CALLE 13 C21
Mailing Address - Street 2:URB. TOA ALTA HEIGHT
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-448-7383
Mailing Address - Fax:
Practice Address - Street 1:CALLE 13 C21
Practice Address - Street 2:URB. TOA ALTA HEIGHT
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-448-7383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 626341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRTC AMB 626OtherAMBULANCE TRANSPORT