Provider Demographics
NPI:1619422581
Name:NSM OB-GYN MEDICAL LLC
Entity Type:Organization
Organization Name:NSM OB-GYN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NITZA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:SERRANO-MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-594-3204
Mailing Address - Street 1:PO BOX 1765
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-1765
Mailing Address - Country:US
Mailing Address - Phone:787-594-3204
Mailing Address - Fax:
Practice Address - Street 1:1507 AVENIDA PONCE DE LEON
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00909
Practice Address - Country:UM
Practice Address - Phone:787-201-6246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty