Provider Demographics
NPI:1134453210
Name:REAL AMBULANCE INC
Entity type:Organization
Organization Name:REAL AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-478-2050
Mailing Address - Street 1:EXT SAN AGUSTIN CALLE 10 B11
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-478-2050
Mailing Address - Fax:787-764-7796
Practice Address - Street 1:EXT SAN AGUSTIN CALLE 10 B11
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-478-2050
Practice Address - Fax:787-764-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 5973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport