Healthcare Provider Details

I. General information

NPI: 1750660619
Provider Name (Legal Business Name): CRITICAL PULMONARY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2011
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE FD ROOSEVELT CLINICA LAS AMERICAS SUITE 205
SAN JUAN PR
00918-2103
US

IV. Provider business mailing address

400 AVE FD ROOSEVELT CLINICA LAS AMERICAS SUITE 205
SAN JUAN PR
00918-2103
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-1919
  • Fax: 787-763-4049
Mailing address:
  • Phone: 787-765-1919
  • Fax: 787-763-4049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number13628
License Number StatePR

VIII. Authorized Official

Name: DR. CARLOS R. GARCIA
Title or Position: PRESIDENTE
Credential: M.D. F.C.C.P.
Phone: 787-765-1919