Provider Demographics
NPI:1760646590
Name:INFINITY LIFE AMBULANCE INC
Entity type:Organization
Organization Name:INFINITY LIFE AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEFTALY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:166793
Authorized Official - Phone:787-679-0222
Mailing Address - Street 1:PO BOX 5193
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5193
Mailing Address - Country:US
Mailing Address - Phone:787-649-0222
Mailing Address - Fax:
Practice Address - Street 1:CALLED 12 #207
Practice Address - Street 2:URB VEREDA
Practice Address - City:JURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-649-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1667933416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR166793OtherLICENCIA ESTADO
PR4352808OtherLICENCIA CONDUCIR