MEDICARE: CARIBBEAN PULMONARY MEDICAL SOCIETY, C.S.P.

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	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1841329091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARIBBEAN PULMONARY MEDICAL SOCIETY, C.S.P.

Provider Business Mailing Address
First Line	:	PO BOX 7776
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-7776
Country	:	US
Telephone Number	:	787-840-2160
Fax Number	:	787-840-2104

Provider Business Practice Location Address
First Line	:	2431 AVE LAS AMERICAS STE 300
Second Line	:	EDF A PORRATA PILA
City	:	PONCE
State	:	PR
Zip	:	00717-2115
Country	:	US
Telephone Number	:	787-840-2160
Fax Number	:	787-840-2104

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. HELLITZ BELLIDO
Credential	:	CCS-P,CMRS
Telephone Number	:	787-598-1949

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	03/16/2010

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