Healthcare Provider Details

I. General information

NPI: 1689655144
Provider Name (Legal Business Name): AMMVR GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 AVE DOMENECH
SAN JUAN PR
00918-3520
US

IV. Provider business mailing address

PO BOX 195519
SAN JUAN PR
00919-5519
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-0807
  • Fax: 787-753-4453
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 Number972
License Number StatePR

VIII. Authorized Official

Name: MR. CESAR RAMIREZ
Title or Position: DIRECTOR FINANZAS
Credential:
Phone: 787-999-2990