Healthcare Provider Details

I. General information

NPI: 1437552221
Provider Name (Legal Business Name): ASOCIACIONDEMEDICOSMSINC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#21 CALLE TULIPAN URB. VICTORIA
AGUADILLA PR
00603
US

IV. Provider business mailing address

PLAZA 7 MA 36 URB. MONTE CLARO
BAYAMON PR
00961-0961
US

V. Phone/Fax

Practice location:
  • Phone: 787-314-6825
  • Fax: 787-658-6218
Mailing address:
  • Phone: 787-314-6825
  • Fax: 787-658-6218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StatePR

VIII. Authorized Official

Name: MR. MERVIN SANCHEZ
Title or Position: PRESIDENTE
Credential:
Phone: 787-314-6825