Provider Demographics
NPI:1902112121
Name:BRAVO AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:BRAVO AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MISS
Authorized Official - First Name:TOMASITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-753-2347
Mailing Address - Street 1:1777 PATRICIA LN
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-7898
Mailing Address - Country:US
Mailing Address - Phone:956-728-7777
Mailing Address - Fax:956-728-7788
Practice Address - Street 1:1224 PASEO DE NEVA
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-7600
Practice Address - Country:US
Practice Address - Phone:956-728-7777
Practice Address - Fax:956-728-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport