# DIVINO NINO MEDICAL TRANSPORT LLC

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

## Provider details

- **NPI number:** 1710112990
- **Authorized official:** MR. LUIS F MORALES (PRESIDENTE)
- **Authorized official phone:** (787) 845-2290

## Contact information

- **Practice address:** CARR 5507 KM 0.1, BO VELAZQUEZ, SANTA ISABEL, PR 00757
- **Practice address phone:** (787) 845-2290
- **Mailing address:** PO BOX 1900, OROCOVIS, PR 00720-1900
- **Mailing address phone:** (787) 845-2290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TC AMB 542 | PR | Yes |

## Other

- **Enumeration date:** 05/18/2009
- **Last updated:** 02/04/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | TC AMB 542 | COMISION DE SERVICIO PUBLICO | PR |