# MEDICAL SERVICE OF PR CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215324157
- **Authorized official:** DR. VICTOR M SIMONS MD (PRESIDENT)
- **Authorized official phone:** (787) 316-1514

## Contact information

- **Practice address:** CALLE CORCHADO FINAL, CDT CANOVANAS, CANOVANAS, PR 00729
- **Practice address phone:** (787) 876-5000
- **Practice address fax:** (787) 876-2422
- **Mailing address:** PO BOX 1649, CANOVANAS, PR 00729-1649
- **Mailing address phone:** (787) 876-5000
- **Mailing address fax:** (787) 876-2422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2015
- **Last updated:** 04/17/2015