Healthcare Provider Details
I. General information
NPI: 1437364171
Provider Name (Legal Business Name): BAM MEDICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2007
Last Update Date: 07/21/2022
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
- Phone: 787-781-7161
- Fax: 787-292-0130
- Phone: 787-781-7161
- Fax: 787-292-0130
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | PR |
VIII. Authorized Official
Name: DR.
LORENZO
E
BOSQUE
Title or Position: PRESIDENT
Credential: MD
Phone: 787-781-7161