Active NPI
Life Care Medical Transport Inc
- Land Ambulance
- Moca, PR
National Provider Identifier
1093472011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- LIFE CARE MEDICAL TRANSPORT INC
- Practice address
- Carr 111 KM 6.3 Bo. Pueblo
Moca, PR 00676 - Phone
- (787) 236-0563
- Fax
- (787) 777-1577
- NPI assigned
- Nov 24, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacqueline Romero Gonzalez
- Title
- Presidente
- Phone
- (787) 236-0563
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
Carr 111 KM 6.3 Bo. Pueblo
Moca, PR 00676
Mailing address
PO Box 382
Moca, PR 00676-0382
Phone (787) 236-0563
Other names 1
- LIFE CARE MEDICAL TRANSPORT INC
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mildred@quinterogrouppr.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221021000024 | PR | Part B Supplier - Ambulance Service Supplier | 0244606945 | Practice locations: Moca, PR |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1637712000000",
"number": "1093472011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 382",
"city": "MOCA",
"state": "PR",
"postal_code": "006760382",
"telephone_number": "787-236-0563",
"fax_number": "787-777-1577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 111 KM 6.3 BO. PUEBLO",
"city": "MOCA",
"state": "PR",
"postal_code": "00676",
"telephone_number": "787-236-0563",
"fax_number": "787-777-1577"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE CARE MEDICAL TRANSPORT INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-11-24",
"last_updated": "2021-11-24",
"certification_date": "2021-11-11",
"status": "A",
"authorized_official_last_name": "ROMERO GONZALEZ",
"authorized_official_first_name": "JACQUELINE",
"authorized_official_title_or_position": "PRESIDENTE",
"authorized_official_telephone_number": "787-236-0563"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mildred@quinterogrouppr.com",
"affiliation": "N",
"endpointDescription": "mildred@quinterogrouppr.com",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "mildred@quinterogrouppr.com",
"address_1": "CARR 111 KM 6.3 BO. PUEBLO",
"city": "MOCA",
"state": "PR",
"country_code": "US",
"postal_code": "00676",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "LIFE CARE MEDICAL TRANSPORT INC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Moca, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.