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General NPI Number Information
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NPI Number | 1558743195
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Entity Type | Organization
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Legal Business Name | SALUD INTEGRAL EN LA MONTANA, INC
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 53 CALLE BARCELO CARR 156
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City | BARRANQUITAS
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State | PR
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Zip | 00794
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Country | US
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Telephone | 787-869-5900
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Fax | 787-869-6120
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Provider Business Mailing Address
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Address Line | PO BOX 515
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City | NARANJITO
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State | PR
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Zip | 00719-0515
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Country | US
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Telephone | 787-869-5900
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Fax | 787-869-6120
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | ANGEL VEGA
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Credential |
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Telephone | 787-869-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 127
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License Number State | PR
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