Provider Demographics
NPI:1487312542
Name:VITAL CARE AMBULANCE LLC
Entity type:Organization
Organization Name:VITAL CARE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:GLORIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-529-4504
Mailing Address - Street 1:URB PUERTO NUEVO
Mailing Address - Street 2:362 PMB 203 AVE ANDALUCIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4103
Mailing Address - Country:US
Mailing Address - Phone:787-423-8885
Mailing Address - Fax:
Practice Address - Street 1:401 ANDALUCIA EDIF 401
Practice Address - Street 2:OFICINA AN3
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-0998
Practice Address - Country:US
Practice Address - Phone:787-438-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)