Provider Demographics
NPI:1477102424
Name:SERVICIOS MEDICOS DEL OESTE
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS DEL OESTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-868-2365
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-0056
Mailing Address - Country:US
Mailing Address - Phone:787-868-2365
Mailing Address - Fax:
Practice Address - Street 1:BARRIO MALPASO
Practice Address - Street 2:CARR 417 KM 3.0
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-0060
Practice Address - Country:US
Practice Address - Phone:787-868-2365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care