Provider Demographics
NPI:1316012172
Name:SERVICIOS ANSILARES CESMI CORP.
Entity Type:Organization
Organization Name:SERVICIOS ANSILARES CESMI CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:CANDELAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-778-0315
Mailing Address - Street 1:PO BOX 6598
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-5598
Mailing Address - Country:US
Mailing Address - Phone:787-778-0315
Mailing Address - Fax:787-778-0330
Practice Address - Street 1:SANTA CRUZ STREET
Practice Address - Street 2:# 59
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6900
Practice Address - Country:US
Practice Address - Phone:787-778-2100
Practice Address - Fax:787-778-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center