# EVOLUTION MEDICAL AMBULANCE CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EVOLUTION MEDICAL AMBULANCE CORP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104152099
- **Authorized official:** MARISOL RIVERA JIMENEZ (PROPIETARIA)
- **Authorized official phone:** (787) 381-4475

## Contact information

- **Practice address:** CARR 111 KM 26 HM1, PIEDRAS BLANCAS, SAN SEBASTIAN, PR 00685
- **Practice address phone:** (787) 381-4475
- **Mailing address:** P O BOX 2234, SAN SEBASTIAN, PR 00685
- **Mailing address phone:** (787) 381-4475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | CP- 4521 | PR | Yes |

## Other

- **Enumeration date:** 10/27/2009
- **Last updated:** 09/01/2010