Healthcare Provider Details

I. General information

NPI: 1437364148
Provider Name (Legal Business Name): MAB MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTEHIEDRA 145 GUARAGUAO ST
SAN JUAN PR
00926-0000
US

IV. Provider business mailing address

MONTEHIEDRA 145 GUARAGUAO ST
SAN JUAN PR
00926-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-760-6604
  • Fax: 787-292-0130
Mailing address:
  • Phone: 787-760-6604
  • Fax: 787-292-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. LORENZO E BOSQUE
Title or Position: PRESIDENT
Credential: MD
Phone: 787-781-7161