Organization
ASOCIACION MEDICOS SELECTOS DE LA MONTANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTONIA RODRIGUEZ (ADMINISTRATOR)
(939) 717-3634
Entity
Organization
Contact information
Practice address
56 CALLE GEORGETTI, NARANJITO, PR 00719-3000
(939) 717-3634
Mailing address
56 CALLE GEORGETTI, NARANJITO, PR 00719-3000
(939) 717-3634
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IPA-341
TRIPLE S, INC.
PR
Enumeration date
06/08/2008
Last updated
06/08/2008
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