Healthcare Provider Details

I. General information

NPI: 1265534598
Provider Name (Legal Business Name): TRESAMICI MANAGEMENT,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 BOLIVAR PAGAN URB SAN MARTIN
SAN JUAN PR
00918-3549
US

IV. Provider business mailing address

1019 SAN MARTIN BOLIVAR PAGAN
CAROLINA PR
00918-3549
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-4242
  • Fax:
Mailing address:
  • Phone: 787-758-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number50
License Number StatePR

VIII. Authorized Official

Name: MR. JESUS F MENDEZ
Title or Position: OWNER
Credential: CPA
Phone: 787-758-4242