Provider Demographics
NPI:1558711473
Name:PLATINUM MEDICAL SERVICES, PSC
Entity Type:Organization
Organization Name:PLATINUM MEDICAL SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:NEGRON
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-545-2718
Mailing Address - Street 1:130 AVE WINSTON CHURCHILL
Mailing Address - Street 2:PMB 359 SUITE 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6065
Mailing Address - Country:US
Mailing Address - Phone:787-545-2718
Mailing Address - Fax:787-545-2794
Practice Address - Street 1:900 CALLE CERRA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-5104
Practice Address - Country:US
Practice Address - Phone:787-545-2718
Practice Address - Fax:787-545-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14379OtherLICENSE