Healthcare Provider Details
I. General information
NPI: 1063806008
Provider Name (Legal Business Name): NRMD HEALTH PROVIDERS PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2015
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 AVE PONCE DE LEON SUITE 206 SANTURCE MEDICAL MALL
SAN JUAN PR
00909-1900
US
IV. Provider business mailing address
PO BOX 19237
SAN JUAN PR
00910-1237
US
V. Phone/Fax
- Phone: 787-727-8227
- Fax: 787-728-4163
- Phone: 787-722-8227
- Fax: 787-728-4163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARIA
E
NARVAEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-727-8227