Organization
LUQUILLO MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOMAS J HERNANDEZ (PRESIDENT)
(787) 500-7752
Entity
Organization
Contact information
Practice address
159 CALLE 14 JULIO, LUQUILLO, PR 00773
(787) 500-7752
Mailing address
159 CALLE 14 DE JULIO, LUQUILLO, PR 00773
(787) 500-7752
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
—
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IG717A
MEDICARE PTAN
PR
Enumeration date
03/10/2016
Last updated
03/10/2016
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