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General NPI Number Information
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NPI Number | 1427997758
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Entity Type | Organization
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Legal Business Name | SUMMITCARE MEDICAL LLC
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | CENTRO PROFESIONAL DEL SUR CARR 121 KM 13.3 ECTOR CUATRO CALLES
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-813-2385
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 332228
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City | PONCE
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State | PR
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Zip | 00733-2228
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Country | US
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Telephone | 787-813-2385
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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. NELSON RADAMES MEDINA MORENO
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Credential | MD
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Telephone | 787-813-2385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy 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 | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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