Provider Demographics
NPI:1295060945
Name:MEDIEXPREESS
Entity type:Organization
Organization Name:MEDIEXPREESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GERENTE
Authorized Official - Prefix:MISS
Authorized Official - First Name:ESCALERA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CARLA
Authorized Official - Suffix:
Authorized Official - Credentials:GERENTE
Authorized Official - Phone:787-909-0043
Mailing Address - Street 1:ARZUAGA 112 SUITE 605
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925
Mailing Address - Country:US
Mailing Address - Phone:787-909-0043
Mailing Address - Fax:
Practice Address - Street 1:ARZUAGA 112 SUITE 605
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3316
Practice Address - Country:US
Practice Address - Phone:787-646-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty