Provider Demographics
NPI:1982726790
Name:JOSE DANIEL MERCADO GALARZA
Entity Type:Organization
Organization Name:JOSE DANIEL MERCADO GALARZA
Other - Org Name:PUERTO RICO EMERGENCY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-818-0911
Mailing Address - Street 1:PO BOX 1875
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1875
Mailing Address - Country:US
Mailing Address - Phone:787-818-0911
Mailing Address - Fax:787-818-0911
Practice Address - Street 1:CARR 444 KM 1.1
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB-3123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0056685Medicare ID - Type UnspecifiedAMBULANCE SERVICE