Provider Demographics
NPI:1306186432
Name:MULTIDISCIPLINARY MEDICAL SERVICE LLC
Entity Type:Organization
Organization Name:MULTIDISCIPLINARY MEDICAL SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFICINISTA ADM.
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-852-2470
Mailing Address - Street 1:216 VILLA STATION
Mailing Address - Street 2:VILLA UNIVERSITARIA
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-852-2470
Mailing Address - Fax:787-285-4165
Practice Address - Street 1:CALLE LUIS MUNOZ MARIN
Practice Address - Street 2:ESQUINA ULISES MARTINEZ 55
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-2470
Practice Address - Fax:787-285-4165
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUMET INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-27
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty