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General NPI Number Information
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NPI Number | 1992773980
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Entity Type | Organization
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Legal Business Name | SERVICIOS MEDICOS DE HORMIGUEROS INC
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | CALLE LUIS MUNOZ MARTIN 2
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City | HORMIGUEROS
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State | PR
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Zip | 00660
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Country | US
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Telephone | 787-849-0111
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Fax | 787-849-0707
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Provider Business Mailing Address
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Address Line | PO BOX 1520
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City | HORMIGUEROS
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State | PR
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Zip | 00660-1520
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Country | US
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Telephone | 787-849-0111
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Fax | 787-849-0707
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Authorized Official
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Title or Position | PRESIDENTE
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Name | JOSE M ROVIRA
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Credential | MD
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Telephone | 787-849-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 44
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 44
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 740
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 44
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License Number State | PR
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