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General NPI Number Information
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NPI Number | 1811256589
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Entity Type | Organization
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Legal Business Name | YAMCELY MEDICAL SERVICES CSP
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | BO COCO NUEVO 360 CALLE SANTIAGO IGLESIAS
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City | SALINAS
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State | PR
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Zip | 00751-2550
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Country | US
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Telephone | 787-824-0050
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Fax | 787-824-0050
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Provider Business Mailing Address
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Address Line | PO BOX 134
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City | SALINAS
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State | PR
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Zip | 00751-0134
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Country | US
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Telephone | 787-824-0050
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Fax | 787-824-0050
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YAMIL MATEO - MORENO
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Credential | MD
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Telephone | 787-824-0050
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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 | 4307-711
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License Number State | PR
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