Healthcare Provider Details

I. General information

NPI: 1770907818
Provider Name (Legal Business Name): CMS HOME CARE SUR, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/26/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 CARR 506 STE 202 - COTO LAUREL
PONCE PR
00780-2936
US

IV. Provider business mailing address

PO BOX 3569
CAROLINA PR
00984-3569
US

V. Phone/Fax

Practice location:
  • Phone: 787-290-1100
  • Fax: 787-841-4664
Mailing address:
  • Phone: 787-290-1100
  • Fax: 787-841-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA J. MENDEZ
Title or Position: CHIEF OPERATIONAL OFFICER
Credential:
Phone: 787-620-2900