Organization Name: | SERVICIOS MEDICOS PENA POBRE, P.S.C. |
NPI Number: | 1750711347 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ABNER MERCADO DIAZ (PRESIDENTE) |
Mailing Address: | Parcela 3117 Barrio Pena Pobre Naguabo |
State: | PR US |
Postal Code: | 00718 |
Phone Number: | 7878743037 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2013 |
NPI Last Update Date: | 11/18/2013 |
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: |