Healthcare Provider Details

I. General information

NPI: 1538318639
Provider Name (Legal Business Name): SPM DOCTORS SERVICES GROUP PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B7 CALLE SANTA CRUZ
BAYAMON PR
00961-6902
US

IV. Provider business mailing address

B7 CALLE SANTA CRUZ
BAYAMON PR
00961-6902
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-9196
  • Fax: 787-778-2904
Mailing address:
  • Phone: 787-780-9196
  • Fax: 787-778-2904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ILIA E ZAYAS-TORO
Title or Position: CMO
Credential: MD
Phone: 787-780-9196