Provider Demographics
NPI:1538686712
Name:S.M MEDICAL SERVICES, C.S.P.
Entity Type:Organization
Organization Name:S.M MEDICAL SERVICES, C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-800-1081
Mailing Address - Street 1:237 CALLE MELAO
Mailing Address - Street 2:URBANIZACION HACIENDA MARGARITA
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773
Mailing Address - Country:US
Mailing Address - Phone:787-800-1081
Mailing Address - Fax:787-655-7486
Practice Address - Street 1:S-58 AVENIDA CAONQUISTADOR VALLE VERDE
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-655-7486
Practice Address - Fax:787-655-7486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11387261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========Medicaid