Provider Demographics
NPI:1154618304
Name:JENSEN J FELICIANO-MUNIZ
Entity type:Organization
Organization Name:JENSEN J FELICIANO-MUNIZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENSEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FELICIANO-MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-669-0374
Mailing Address - Street 1:HC 1 BOX 6670
Mailing Address - Street 2:CARR 110 KM 5 HM 4
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9529
Mailing Address - Country:US
Mailing Address - Phone:787-669-0374
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 6670
Practice Address - Street 2:CARR 110 KM 5 HM 4
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-9529
Practice Address - Country:US
Practice Address - Phone:787-669-0374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB 6753416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport