Healthcare Provider Details

I. General information

NPI: 1063537983
Provider Name (Legal Business Name): SERVICIOS MEDICOS LAS MARIAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. LUCCETTI #9
MARICAO PR
00606
US

IV. Provider business mailing address

P.O. BOX 23
LAS MARIAS PR
00670
US

V. Phone/Fax

Practice location:
  • Phone: 787-838-2100
  • Fax: 787-838-2075
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: SAUL RIOS
Title or Position: VICE PRESIDENTE FINANZAS
Credential: MBA
Phone: 787-827-2230