Provider Demographics
NPI:1437364171
Name:BAM MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:BAM MEDICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOSQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-781-7161
Mailing Address - Street 1:MONTEHIEDRA
Mailing Address - Street 2:145 GUARAGUAO ST
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0000
Mailing Address - Country:US
Mailing Address - Phone:787-781-7161
Mailing Address - Fax:787-292-0130
Practice Address - Street 1:MONTEHIEDRA
Practice Address - Street 2:145 GUARAGUAO ST
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0000
Practice Address - Country:US
Practice Address - Phone:787-781-7161
Practice Address - Fax:787-292-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherSEG SOC