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General NPI Number Information
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NPI Number | 1912367772
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Entity Type | Organization
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Legal Business Name | SERVICIOS MEDICOS PEDIATRICOS
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 17 MAIN AND CALLE CIBELES EL RETIRO HOUSING
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City | SAN GERMAN
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State | PR
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Zip | 00683-4459
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Country | US
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Telephone | 787-892-8899
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Fax | 787-892-8899
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Provider Business Mailing Address
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Address Line | 17 CALLE CIBELES Y PRINCIPAL EXT.EL RETIRO
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City | SAN GERMAN
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State | PR
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Zip | 00683-4459
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Country | US
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Telephone | 787-892-8899
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Fax | 787-892-8899
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Authorized Official
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Title or Position | CHIEF
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Name | DR. SOL MARIA GARCIA
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Credential | M.D.
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Telephone | 787-519-1764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 15351
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License Number State | PR
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