Healthcare Provider Details

I. General information

NPI: 1760698096
Provider Name (Legal Business Name): ADM SERVICIOS MEDICOS DE PUERTO RICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE AMERICO MIRANDA NO 22 BO MONACILLOS
SAN JUAN PR
00922-2129
US

IV. Provider business mailing address

PO BOX 2129
SAN JUAN PR
00922-2129
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3483
  • Fax: 787-777-3481
Mailing address:
  • Phone: 787-777-3483
  • Fax: 787-777-3481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE RIVERA RIVERA CARTAGENA SR.
Title or Position: BILLER OFFICER
Credential:
Phone: 787-777-3535