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General NPI Number Information
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NPI Number | 1750661831
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Entity Type | Organization
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Legal Business Name | SUR PEDIATRIC EMERGENCY SERVICES, PSC
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | LA FUENTE TOWN CENTER SUITE 11123
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City | GUAYAMA
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State | PR
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Zip | 00784-7333
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Country | US
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Telephone | 787-866-1129
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Fax |
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Provider Business Mailing Address
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Address Line | 15 PARQ INTERAMERICANA
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City | GUAYAMA
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State | PR
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Zip | 00784-7333
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Country | US
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Telephone | 787-866-1129
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Fax | 787-866-1129
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY QUINONES
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Credential | MD
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Telephone | 787-866-1129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10485
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License Number State | PR
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