Healthcare Provider Details

I. General information

NPI: 1932878121
Provider Name (Legal Business Name): ASOCIACION DE MEDICOS DE PR MS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/10/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB MONTE CLARO CLARO MA 36 URB MONTE CLARO CLARO MA 36
BAYAMON PR
00961
US

IV. Provider business mailing address

URB MONTE CLARO CLARO MA 36 URB MONTE CLARO CLARO MA 36
BAYAMON PR
00961
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. MERVIN SANCHEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-314-6625