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General NPI Number Information
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NPI Number | 1669615522
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Entity Type | Organization
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Legal Business Name | C&M MEDICAL SERVICES, P.S.C
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | NUM. 27 VILLA NEVAREZ CONDOMINIO LOS OLMOS SUITE 7A
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-604-0236
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1004
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-1004
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Country | US
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Telephone | 787-604-0236
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Fax |
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Authorized Official
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Title or Position | INCORPORATOR
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Name | DR. CASANDRA MEDINA
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Credential | M.D.
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Telephone | 787-604-0236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17253
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License Number State | PR
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