# LIGTHTING AMBULANCE TRANSPORT CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063692671
- **Authorized official:** DEREK LOPEZ (PRESIDENT)
- **Authorized official phone:** (787) 738-9657

## Contact information

- **Practice address:** G23 CALLE C, URB. REPARTO MONTELLANO, CAYEY, PR 00736-4133
- **Practice address phone:** (787) 738-9657
- **Mailing address:** PO BOX 6400, CAYEY, PR 00737-6400
- **Mailing address phone:** (787) 738-9657

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TCAMB-461 | PR | Yes |

## Other

- **Enumeration date:** 11/12/2007
- **Last updated:** 11/12/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | TCAMB-461 | STATE LICENSE | PR |