Healthcare Provider Details

I. General information

NPI: 1992401707
Provider Name (Legal Business Name): BNM MEDICAL SERVICES PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 CALLE CARAZO
GUAYNABO PR
00969-5708
US

IV. Provider business mailing address

1757 CALLE R LOPEZ LANDRON URB. SANTIAGO IGLESIAS
SAN JUAN PR
00921-4522
US

V. Phone/Fax

Practice location:
  • Phone: 787-234-8235
  • Fax:
Mailing address:
  • Phone: 787-234-8235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BENNY NIEVES
Title or Position: PRESIDENT / CEO
Credential: MD
Phone: 787-234-8235