Organization Name: | SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C. |
NPI Number: | 1225274178 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AGAPITO FONTANEZ (PRESIDENT) |
Mailing Address: | Calle Principal I-23 Urb. Baralt Fajardo |
State: | PR US |
Postal Code: | 00738 |
Phone Number: | 7878637646 |
Fax Number: | 7878607357 |
NPI Enumeration Date: | 12/24/2008 |
NPI Last Update Date: | 08/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |