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General NPI Number Information
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NPI Number | 1376995266
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Entity Type | Organization
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Legal Business Name | PUERTO RICO MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 07/05/2016
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Last Update Date | 07/05/2016
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Provider Practice Location Address
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Address Line | 540 CARR 169 APT 1006
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City | GUAYNABO
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State | PR
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Zip | 00969-4275
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Country | US
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Telephone | 939-227-9680
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Fax | 787-277-1573
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Provider Business Mailing Address
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Address Line | 540 CARR 169 APT 1006
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City | GUAYNABO
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State | PR
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Zip | 00969-4275
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Country | US
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Telephone | 939-227-9680
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Fax | 787-277-1573
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEONARDO VAZQUEZ
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Credential |
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Telephone | 939-227-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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