Provider Demographics
NPI:1174916944
Name:SOUTH AMBULANCE LIFE CORP
Entity type:Organization
Organization Name:SOUTH AMBULANCE LIFE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-316-7357
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-0089
Mailing Address - Country:US
Mailing Address - Phone:787-316-7357
Mailing Address - Fax:787-824-4176
Practice Address - Street 1:CARR 1 KM 88
Practice Address - Street 2:SECTOR GODREAU LOTE 2
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-824-4919
Practice Address - Fax:787-824-4176
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SOUTH AMBULANCE LIFE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7583416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport