Healthcare Provider Details

I. General information

NPI: 1376953695
Provider Name (Legal Business Name): CSM SERVICIOS DE CUIDADO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HF16 CALLE LIZZIE GRAHAM SEPTIMA SECCION LEVITTOWN
TOA BAJA PR
00949-3634
US

IV. Provider business mailing address

HF16 CALLE LIZZIE GRAHAM SEPTIMA SECCION LEVITTOWN
TOA BAJA PR
00949-3634
US

V. Phone/Fax

Practice location:
  • Phone: 787-795-2935
  • Fax: 787-784-0680
Mailing address:
  • Phone: 787-795-2935
  • Fax: 787-784-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLOS R MOYKA
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D.
Phone: 787-795-2935