Healthcare Provider Details

I. General information

NPI: 1457261695
Provider Name (Legal Business Name): MSS OF PONCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 HARBOUR LIGHTS DR
HUMACAO PR
00791-6053
US

IV. Provider business mailing address

46 HARBOUR LIGHTS DR
HUMACAO PR
00791-6053
US

V. Phone/Fax

Practice location:
  • Phone: 787-697-0046
  • Fax:
Mailing address:
  • Phone: 787-697-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUIS E SANTINI RIVERA
Title or Position: PRESIDENT
Credential:
Phone: 787-733-5656