MEDICARE: SALUD INTEGRAL EN LA MONTANA, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	261Q00000X	Clinic/Center	PR
2	261QP2300X	Primary Care Clinic/Center	PR
3	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1639372618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALUD INTEGRAL EN LA MONTANA, INC.

Provider Business Mailing Address
First Line	:	PO BOX 515
Second Line	:
City	:	NARANJITO
State	:	PR
Zip	:	00719-0515
Country	:	US
Telephone Number	:	787-869-5900
Fax Number	:	787-869-6120

Provider Business Practice Location Address
First Line	:	CALLE JOSE DE DIEGO
Second Line	:	ESQUINA CALLE BARCELO 23
City	:	TOA ALTA
State	:	PR
Zip	:	00953-2426
Country	:	US
Telephone Number	:	787-870-0008
Fax Number	:	787-870-0046

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. GLORIA DEL C. AMADOR FERNANDEZ
Credential	:
Telephone Number	:	787-869-5900

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	01/12/2026

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