Healthcare Provider Details
I. General information
NPI: 1639367154
Provider Name (Legal Business Name): CSM SERVICIOS DE CUIDADO INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2007
Last Update Date: 05/06/2008
Certification Date:
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
- Phone: 787-795-2911
- Fax: 787-784-0680
- Phone: 787-795-2911
- Fax: 787-784-0680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CARLOS
R
MOYKA
Title or Position: DIRECTOR
Credential: M.D.
Phone: 787-795-2911