# LUCIANO ROMAN GONZALEZ

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUPER AMBULANCE SERVICES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407874050
- **Authorized official:** MR. LUCIANO ROMAN (OWNER-ADMINISTRATOR)
- **Authorized official phone:** (787) 898-4442

## Contact information

- **Practice address:** CARR \#2 KM. 95.3, BO. YEGUADA, CAMUY, PR 00627
- **Practice address phone:** (787) 898-4442
- **Practice address fax:** (787) 898-4442
- **Mailing address:** PO BOX 458, QUEBRADILLAS, PR 00678-0458
- **Mailing address phone:** (787) 898-4442
- **Mailing address fax:** (787) 898-4442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TCAMB334 | PR | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 50518 | AMBULANCE SERVICE | PR |
| 01 | — | 56917 | AMBULANCE SERVICES | PR |
| 01 | — | 9004424 | AMBULANCE SERVICE | PR |