Provider Demographics
NPI:1952401119
Name:NATIONAL AMBULANCE
Entity Type:Organization
Organization Name:NATIONAL AMBULANCE
Other - Org Name:JOSE A. PESANTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PESANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-367-8681
Mailing Address - Street 1:518 CALLE ARNEDO
Mailing Address - Street 2:URB. VALENCIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-1845
Mailing Address - Country:US
Mailing Address - Phone:787-367-8681
Mailing Address - Fax:
Practice Address - Street 1:518 CALLE ARNEDO
Practice Address - Street 2:URB. VALENCIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-1845
Practice Address - Country:US
Practice Address - Phone:787-367-8681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 913416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059220Medicare PIN