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General NPI Number Information
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NPI Number | 1154629616
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Entity Type | Organization
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Legal Business Name | STRATEGIC MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 334 CALLE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3229
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Country | US
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Telephone | 787-852-0886
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Fax | 787-852-0280
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | HUMACAO
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State | PR
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Zip | 00792-0428
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Country | US
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Telephone | 787-852-0886
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Fax | 787-852-0280
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AGUSTIN JUAN LOPEZ- COVAS
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Credential | MD
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Telephone | 787-852-0886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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