Organization
MSO OF PUERTO RICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE RIVERA PESANTE (CHIEF FINANCIAL OFFICER)
(787) 622-3000
Entity
Organization
Contact information
Practice address
350 CHARDON AVE, TORRE CHARDON SUITE 600, SAN JUAN, PR 00918
(787) 622-3000
Mailing address
350 CHARDON AVE, TORRE CHARDON SUITE 600, SAN JUAN, PR 00918
(787) 622-3000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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