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General NPI Number Information
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NPI Number | 1063761153
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Entity Type | Organization
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Legal Business Name | MEDICAL STAR SERVICES INC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | U-25 URB. CIUDAD UNIVERSITARIA CARR. 846
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-2209
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Country | US
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Telephone | 787-607-4192
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70250
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City | SAN JUAN
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State | PR
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Zip | 00936-8250
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Country | US
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Telephone | 787-607-4192
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGEL L SENQUIZ
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Credential | M.D., PEDIATRIC
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Telephone | 787-607-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 5367
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License Number State | PR
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