Healthcare Provider Details
I. General information
NPI: 1689469736
Provider Name (Legal Business Name): STARPA MEDICAL SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
JESUS T. PINERO BULDING FERNANDEZ JUNCOS AVENUE BO PUEBLO
CAROLINA PR
00985
US
IV. Provider business mailing address
VALLES DEL LAGO CALLE GUAJATACA 1069
CAGUAS PR
00725
US
V. Phone/Fax
- Phone: 787-647-9641
- Fax:
- Phone: 787-647-9641
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PEDRO
RIVERA CABALLERO
Title or Position: OWNER
Credential: MD
Phone: 787-647-9641