Healthcare Provider Details

I. General information

NPI: 1548389380
Provider Name (Legal Business Name): SERVICIOS MEDICOS LAS MARIAS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. FLAMBOYAN NO. 237
LAJAS PR
00667
US

IV. Provider business mailing address

PO BOX 23
LAS MARIAS PR
00670-0023
US

V. Phone/Fax

Practice location:
  • Phone: 787-899-4242
  • Fax: 787-899-8023
Mailing address:
  • Phone: 787-827-2230
  • Fax: 787-827-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name: ROBERTO I RUIZ
Title or Position: ADMINISTRADOR
Credential: MHSA
Phone: 787-827-2230