# MEDICAL TRANSPORT AMBULANCE INC

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

## Provider details

- **NPI number:** 1659320075
- **Authorized official:** MILAGROS CRUZ (PRESIDENT)
- **Authorized official phone:** (787) 736-4444

## Contact information

- **Practice address:** CALLE C14, URB PORTAL DEL SOL, SAN LORENZO, PR 00754
- **Practice address phone:** (787) 736-4444
- **Mailing address:** PO BOX 966, SAN LORENZO, PR 00754-0966
- **Mailing address phone:** (787) 736-4444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TC AMB 369 | PR | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 08/22/2020