Individual provider Active NPI

Rafael Perez Molina

  • Land Ambulance
  • Hatillo, PR
National Provider Identifier
1346284544
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
TCAMB 406 Issued in PR
Practice address
Carr Num 2 KM 84.7 Bo Carrizales
Urb Alturas Calle Jardin Ste 3
Hatillo, PR 00659-0000
Phone
(939) 645-6744
Fax
(787) 820-7500
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X TCAMB 406 PR Primary

Addresses

Primary practice location

Carr Num 2 KM 84.7 Bo Carrizales
Urb Alturas Calle Jardin Ste 3
Hatillo, PR 00659-0000

Mailing address

PO Box 951
Hatillo, PR 00659-0951
Phone (939) 645-6744

Other identifiers 3

IdentifierTypeStateIssuer
57983ANOtherPRSSS REFORMA
50886OtherPRPMC
890775OtherPRMMM

Other names 1

  • Angel Life Ambulance Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060808000105 PR Part B Supplier - Ambulance Service Supplier 6103829486 Practice locations: Hatillo, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TCAMB 406PRMDLand Ambulance

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1346284544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006590951",
            "telephone_number": "939-645-6744",
            "fax_number": "787-820-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR NUM 2 KM 84.7 BO CARRIZALES",
            "address_2": "URB ALTURAS CALLE JARDIN STE 3",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006590000",
            "telephone_number": "939-645-6744",
            "fax_number": "787-820-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ MOLINA",
        "first_name": "RAFAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PR",
            "license": "TCAMB 406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS REFORMA",
            "identifier": "57983AN",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMC",
            "identifier": "50886",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "890775",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "AMBULANCE",
            "middle_name": "LIFE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hatillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.