Healthcare Provider Details

I. General information

NPI: 1275333049
Provider Name (Legal Business Name): SERVIMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL MENONITA GUAYAMA URB LA HACIENDA AVE PEDRO ALBIZU CAMPOS
GUAYAMA PR
00784-0011
US

IV. Provider business mailing address

URB PARQUE INTERAMERICANA 68
GUAYAMA PR
00784-7337
US

V. Phone/Fax

Practice location:
  • Phone: 787-381-4257
  • Fax:
Mailing address:
  • Phone: 787-239-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JUAN D ORTIZ RIVERA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-381-4257