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General NPI Number Information
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NPI Number | 1760281158
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Entity Type | Organization
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Legal Business Name | MEDICO POR AMOR, LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | CARR 115 KM 7.4 BARRIO CAGUABO
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 321-474-7657
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1055
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City | RINCON
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State | PR
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Zip | 00677-1055
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Country | US
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Telephone | 321-474-7657
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICDIA LIZ SOSTRE CONCEPCION
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Credential | MD
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Telephone | 321-474-7657
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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 |
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License Number State |
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