Organization Active NPI

Vitalife Ambulance

  • Land Ambulance
  • San Juan, PR
National Provider Identifier
1457078602
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
VITALIFE AMBULANCE
Practice address
1207 A Avenida Americo Miranda
San Juan, PR 00921-1650
Phone
(787) 932-7771
NPI assigned
Oct 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Ada J Rivera Machado
Title
Authorized Official
Phone
(787) 932-7771

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

1207 A Avenida Americo Miranda
San Juan, PR 00921-1650

Mailing address

PO Box 193596
San Juan, PR 00919-3596
Phone (787) 932-7771

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250204000513 PR Part B Supplier - Ambulance Service Supplier 0941730188 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

1207 Ave Americo Miranda
#A
San Juan, PR 00921
Phone (787) 903-5564

1506 Ave Americo Miranda
San Juan, PR 00921

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1457078602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193596",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009193596",
            "telephone_number": "787-932-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 A AVENIDA AMERICO MIRANDA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009211650",
            "telephone_number": "787-932-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIFE AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "RIVERA MACHADO",
        "authorized_official_first_name": "ADA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "787-932-7771"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.