Healthcare Provider Details

I. General information

NPI: 1437510989
Provider Name (Legal Business Name): AMMVR GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 MUNOZ RIVERA AVE HATO REY
SAN JUAN PR
00918
US

IV. Provider business mailing address

PO BOX 195519
SAN JUAN PR
00919-5519
US

V. Phone/Fax

Practice location:
  • Phone: 787-999-2990
  • Fax: 787-764-8809
Mailing address:
  • Phone: 787-999-2990
  • Fax: 787-764-8809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number338
License Number StatePR

VIII. Authorized Official

Name: MR. EDUARDO ARTAU
Title or Position: PRESIDENT
Credential:
Phone: 787-620-9770