# ALLIED SELECT MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1992036974
- **Authorized official:** MR. LUIS ARIEL SANTOS AMEZAGA BBA (DATA ANALYST)
- **Authorized official phone:** (787) 862-4417

## Contact information

- **Practice address:** 5 CALLE BUENA VIS, SUITE 1, MOROVIS, PR 00687-3042
- **Practice address phone:** (787) 862-4417
- **Practice address fax:** (787) 862-7646
- **Mailing address:** PO BOX 953, MOROVIS, PR 00687-0953
- **Mailing address phone:** (787) 862-4417
- **Mailing address fax:** (787) 862-7646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 01/15/2010
- **Last updated:** 01/15/2010