Organization
ASOCIACION MEDICOS SELECTOS DE LA MONTANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTONIA RODRIGUEZ (ADMINISTRATOR)
(787) 869-5542
Entity
Organization
Contact information
Practice address
4 CALLE URBANO RAMIREZ, COROZAL, PR 00783-2219
(787) 869-5542
(787) 869-5421
Mailing address
PO BOX 758, COROZAL, PR 00783-0758
(787) 869-5542
(787) 869-5421
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IPA341
TRIPLE S
PR
Enumeration date
02/23/2010
Last updated
02/23/2010
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