Provider Demographics
NPI:1235730821
Name:IOCP MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:IOCP MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS A
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-562-7205
Mailing Address - Street 1:PO BOX 3241
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3241
Mailing Address - Country:US
Mailing Address - Phone:787-833-3333
Mailing Address - Fax:787-652-4609
Practice Address - Street 1:101 MENDEZ VIGO W STE 201
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3800
Practice Address - Country:US
Practice Address - Phone:787-833-8333
Practice Address - Fax:787-652-4609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty