Provider Demographics
NPI:1043341340
Name:CORPORACION PROFESIONAL SERVICIO MEDICO INFANTIL
Entity Type:Organization
Organization Name:CORPORACION PROFESIONAL SERVICIO MEDICO INFANTIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:VELARDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-991-1320
Mailing Address - Street 1:HC 2 BOX 7898
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-9604
Mailing Address - Country:US
Mailing Address - Phone:787-991-1320
Mailing Address - Fax:787-991-1320
Practice Address - Street 1:STREET # 1 HOUSE # 38, URBANIZACION VILLA ROSALES
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-5690
Practice Address - Fax:787-991-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care