Healthcare Provider Details

I. General information

NPI: 1518223825
Provider Name (Legal Business Name): DAMAR OF PUERTO RICO SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FLOR ANTILLANA STREET RESIDENCIAL LLORENS TORRES SAN TURCE
SAN JUAN PR
00907
US

IV. Provider business mailing address

PO BOX 25130
SAN JUAN PR
00928-5130
US

V. Phone/Fax

Practice location:
  • Phone: 787-982-8300
  • Fax:
Mailing address:
  • Phone: 787-396-8165
  • Fax: 787-771-3585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL MAHIQUES
Title or Position: OWNER
Credential:
Phone: 787-396-8165