# GENESIS MEDICAL TRANSPORT

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

## Provider details

- **NPI number:** 1457520108
- **Authorized official:** MR. JUAN M FONSECA TCAMB518 (PRESIDENT)
- **Authorized official phone:** (787) 217-8040

## Contact information

- **Practice address:** 201 CALLE 43, PARCELA FALU, SAN JUAN, PR 00924-3124
- **Practice address phone:** (787) 217-8040
- **Mailing address:** 201 CALLE 43, PARCELA FALU, SAN JUAN, PR 00924-3124
- **Mailing address phone:** (787) 217-8040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TCAMB518 | PR | Yes |

## Other

- **Enumeration date:** 02/27/2008
- **Last updated:** 02/27/2008