Healthcare Provider Details

I. General information

NPI: 1255973772
Provider Name (Legal Business Name): BUEN SAMARITANO MEDICAL BILLING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 AVE SEVERIANO CUEVAS BO CAIMITAL BAJO
AGUADILLA PR
00603
US

IV. Provider business mailing address

PO BOX 4055
AGUADILLA PR
00605-4055
US

V. Phone/Fax

Practice location:
  • Phone: 787-658-0000
  • Fax:
Mailing address:
  • Phone: 787-658-0000
  • Fax: 787-658-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LUIS ALBERTO ACOSTA
Title or Position: FISCAL SERVICE MANAGER
Credential:
Phone: 787-658-0000