MEDICARE: SUR-MED MEDICAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1366425050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUR-MED MEDICAL CORP

Provider Business Mailing Address
First Line	:	PO BOX 1162
Second Line	:
City	:	SALINAS
State	:	PR
Zip	:	00751
Country	:	US
Telephone Number	:	787-824-7097
Fax Number	:	787-824-7655

Provider Business Practice Location Address
First Line	:	8 COLON PACHECO ST
Second Line	:
City	:	SALINAS
State	:	PR
Zip	:	00751
Country	:	US
Telephone Number	:	787-824-7097
Fax Number	:	787-824-7655

Authorized Official
Title or Position	:	PRESIDENT MEDICAL DIRECTOR
Name	:	CARLOS J RODRIGUEZ-MATEO
Credential	:	MD
Telephone Number	:	787-824-7097

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	12/12/2011

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