Healthcare Provider Details

I. General information

NPI: 1760887285
Provider Name (Legal Business Name): OPR MD MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CALLE EDUARTO GEORGETTI
VEGA ALTA PR
00692
US

IV. Provider business mailing address

125 CALLE CIELO RUBI URB CIELO DORADO
VEGA ALTA PR
00692-8814
US

V. Phone/Fax

Practice location:
  • Phone: 787-679-5226
  • Fax: 787-679-5226
Mailing address:
  • Phone: 787-404-3267
  • Fax: 787-679-5226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name: DR. MARIA P PARRILLA PABLOS
Title or Position: DIRECTOR MEDICO
Credential: MD
Phone: 787-404-3267