Healthcare Provider Details

I. General information

NPI: 1427997758
Provider Name (Legal Business Name): SUMMITCARE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO PROFESIONAL DEL SUR CARR 121 KM 13.3 ECTOR CUATRO CALLES
YAUCO PR
00698
US

IV. Provider business mailing address

PO BOX 332228
PONCE PR
00733-2228
US

V. Phone/Fax

Practice location:
  • Phone: 787-813-2385
  • Fax:
Mailing address:
  • Phone: 787-813-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NELSON RADAMES MEDINA MORENO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-813-2385