Provider Demographics
NPI:1154629616
Name:STRATEGIC MEDICAL MANAGEMENT
Entity Type:Organization
Organization Name:STRATEGIC MEDICAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AGUSTIN
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:LOPEZ- COVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-852-0886
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0428
Mailing Address - Country:US
Mailing Address - Phone:787-852-0886
Mailing Address - Fax:787-852-0280
Practice Address - Street 1:334 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3229
Practice Address - Country:US
Practice Address - Phone:787-852-0886
Practice Address - Fax:787-852-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty