Advance Life Care Ambulance LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

ADVANCE LIFE CARE AMBULANCE LLC

Practice address

Carr 162 KM 1.4 Int Bo Asomante
Sector Las Abejas
Aibonito, PR 00705

Phone

(787) 702-1242

NPI assigned

Jun 22, 2022

Organization subpart

No

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

Authorized official

Name

Hector Mercado

Title

President

Phone

(787) 702-1242

Specialties & licenses 1

Addresses

Electronic endpoints 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": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1740911528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 704",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007050704",
            "telephone_number": "787-702-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 162 KM 1.4 INT BO ASOMANTE",
            "address_2": "SECTOR LAS ABEJAS",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-702-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE LIFE CARE AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-702-1242"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "AIBONITO",
            "affiliation": "N",
            "endpointDescription": "CLEARINGHOUSE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "CARR 162 KM 1.4 INT BO ASOMANTE",
            "address_2": "SECTOR LAS ABEJAS",
            "city": "AIBONITO",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• A Tu Bienestar
• Carlos Suarez Abraham, MD
• Ibrahim Abu-Usbaabdel-Fattah
• Jorge Acevedo Orengo, M.D.
• Adaptando El Movimiento LLC
• Wilfredo Afanador Montalvo, M.D.
• Aibonito X Ray Corp
• Aibonito Xray
• Ashley Crystal Albertorio Ortiz, MS, MSW
• Jose Emanuel Alicea Melero

• All providers in Aibonito, PR
• Land Ambulance in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.