Provider Demographics
NPI: | 1356372510 |
---|---|
Name: | CARIBBEAN EMERGENCY MEDICAL SISTEM INC |
Entity type: | Organization |
Organization Name: | CARIBBEAN EMERGENCY MEDICAL SISTEM INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DUENO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VICTOR |
Authorized Official - Middle Name: | GARAY |
Authorized Official - Last Name: | RODRIGUEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 787-373-9909 |
Mailing Address - Street 1: | E28 CALLE DALIA |
Mailing Address - Street 2: | |
Mailing Address - City: | CAROLINA |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00979-1310 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-373-9909 |
Mailing Address - Fax: | |
Practice Address - Street 1: | CALLE EUCALIPTO 2-C #39 LOMAS VERDES |
Practice Address - Street 2: | |
Practice Address - City: | BAYAMON |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00956 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-373-9909 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-06 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 341600000X | Transportation Services | Ambulance |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PR | 59374 | Medicare ID - Type Unspecified |