Healthcare Provider Details

I. General information

NPI: 1932820008
Provider Name (Legal Business Name): NAGUABO MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JUAN R GARZOT NUM 7
NAGUABO PR
00718
US

IV. Provider business mailing address

PO BOX 548
NAGUABO PR
00718-0548
US

V. Phone/Fax

Practice location:
  • Phone: 787-874-0460
  • Fax: 787-874-0125
Mailing address:
  • Phone: 787-874-0460
  • Fax: 787-874-0125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOSE W VALLE -OLIVERAS
Title or Position: OWER
Credential: MD
Phone: 787-220-4011