| Organization Name: | GENESIS MEDICAL TRANSPORT CORP |
| NPI Number: | 1003067943 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUAN M FONSECA (PRESIDENTE) |
| Mailing Address: | 201 Calle 43 Parcelas Falu San Juan |
| State: | PR US |
| Postal Code: | 009243124 |
| Phone Number: | 7872178040 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2008 |
| NPI Last Update Date: | 10/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | TCAMB518 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |