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General NPI Number Information
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NPI Number | 1740647197
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Entity Type | Organization
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Legal Business Name | INSTITUTO DE MEDICINA DE FAMILIA DE LA MONTANA
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | CARR 152 KM 2.3 BO. QUEBRADILLAS
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City | BARRRANQUITAS
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State | PR
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Zip | PR
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Country | UM
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Telephone | 787-857-8383
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Fax | 787-857-4848
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Provider Business Mailing Address
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Address Line | PO BOX 519
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City | BARRANQUITAS
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State | PR
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Zip | 00794-0519
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Country | US
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Telephone | 787-857-8383
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Fax | 787-857-4848
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Authorized Official
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Title or Position | MD
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Name | DR. MADELAINE BERRIOS
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Credential | M.D.
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Telephone | 787-857-8383
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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 | 14324
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License Number State | PR
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