Peach State Ambulance of PR Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

TCAMB 646 Issued in PR

Legal business name

PEACH STATE AMBULANCE OF PR INC

Practice address

Carr Num 2 KM 97.7
Bo Cocos
Quebradillas, PR 00678-9998

Phone

(787) 213-7522

Fax

(787) 551-7104

NPI assigned

Jun 16, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Yasmin De Lacruz Ruiz

Title

President

Phone

(787) 213-7522

Specialties & licenses 2

Addresses

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": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1902127731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CALLE SOCORRO PMB 22",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781854",
            "telephone_number": "787-213-7522",
            "fax_number": "787-895-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR NUM 2 KM 97.7",
            "address_2": "BO COCOS",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006789998",
            "telephone_number": "787-213-7522",
            "fax_number": "787-551-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE AMBULANCE OF PR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "DE LACRUZ RUIZ",
        "authorized_official_first_name": "YASMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-213-7522",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PR",
            "license": "TCAMB 646",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anibal Pagan Romero, M.D.
• Deborah Corinne Parish, M.D.
• Melvin Omar Pastrana
• Anabelle Paz Figueroa, MD
• Maribelle Paz Figueroa
• Yesenia Perez Caraballo, NURSE
• Yelissa Perez Nieves, M.D.
• Andres F Perez Rodriguez, M.D.
• Yarette Elizabeth Perez-Babin, PSY D
• Ingrid Janice Perez, MSW

• Land Ambulance in Quebradillas, PR
• Providers in Quebradillas, 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 Nov 13, 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.