Organization
LIGTHTING AMBULANCE TRANSPORT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK LOPEZ (PRESIDENT)
(787) 738-9657
Entity
Organization
Contact information
Practice address
G23 CALLE C, URB. REPARTO MONTELLANO, CAYEY, PR 00736-4133
(787) 738-9657
Mailing address
PO BOX 6400, CAYEY, PR 00737-6400
(787) 738-9657
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
TCAMB-461
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TCAMB-461
STATE LICENSE
PR
Enumeration date
11/12/2007
Last updated
11/12/2007
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