MEDICARE: TRESAMICI MANAGEMENT,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311Z00000X	Custodial Care Facility	50	PR

General Provider Information

NPI Number	:	1265534598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRESAMICI MANAGEMENT,INC

Provider Business Mailing Address
First Line	:	1019 SAN MARTIN BOLIVAR PAGAN
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00918-3549
Country	:	US
Telephone Number	:	787-758-4242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 BOLIVAR PAGAN URB SAN MARTIN
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3549
Country	:	US
Telephone Number	:	787-758-4242
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JESUS F MENDEZ
Credential	:	CPA
Telephone Number	:	787-758-4242

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	08/22/2020

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