Active NPI
Rafael Perez Molina
- Land Ambulance
- Hatillo, PR
National Provider Identifier
1346284544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- TCAMB 406
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57983AN | Other | PR | SSS REFORMA |
| 50886 | Other | PR | PMC |
| 890775 | Other | PR | MMM |
Other names 1
- Angel Life Ambulance
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| TCAMB 406 | PR | MD | Land 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.