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Organization

PAMG SELECTO, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LUIS M IRIZARRY M.D. (ADMINISTRATOR)
(787) 813-2325
Entity
Organization

Contact information

Practice address
1266 AVE HOSTOS, ESQ. POWER, PONCE, PR 00717-0947
(787) 813-2325
(787) 841-3908
Mailing address
1266 AVE HOSTOS, ESQ. POWER, PONCE, PR 00717-0947
(787) 813-2325
(787) 841-3908

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
07-B-2318
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10733
PR
Enumeration date
01/04/2011
Last updated
01/04/2011
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