Medstar Ambulance Service Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

TC-AMB - 625 Issued in PR

Legal business name

MEDSTAR AMBULANCE SERVICE INC.

Practice address

Carr. 467 KM 4.4 Camaseyes
Aguadilla, PR 00603

Phone

(787) 617-9110

Fax

(787) 890-0724

NPI assigned

Apr 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bethzaida Acevedo

Title

President

Phone

(787) 617-9110

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1104143718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HARRISON",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006031503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 467 KM 4.4 CAMASEYES",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-617-9110",
            "fax_number": "787-890-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "BETHZAIDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-617-9110"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PR",
            "license": "TC-AMB - 625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRO INC",
            "identifier": "186823",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Onellys M Medina Garcia, LND
• Marielis Medina Rosa, RPH
• Annette Medina-Agostini, M.D.
• Ismael Medina-Agostini, MD
• Ismael Medina-Gaud, M.D.
• Maria Mejias
• Belinda Mendez, MS, OTL
• Heriberto Mendez
• Lymaris E Mendez, RPH
• Marilyn Mendez

• Land Ambulance in Aguadilla, PR
• Providers in Aguadilla, PR by specialty
• Land Ambulance in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.

Verify at the official NPI Registry.