Provider Demographics
NPI:1619448701
Name:INTERMEDIC MEDICAL SERVICES PSC
Entity Type:Organization
Organization Name:INTERMEDIC MEDICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-640-7594
Mailing Address - Street 1:D11 CALLE YAGRUMO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1302
Mailing Address - Country:US
Mailing Address - Phone:787-640-7594
Mailing Address - Fax:787-530-2092
Practice Address - Street 1:BO RINCON SECTOR LOMAS
Practice Address - Street 2:CARRETERA 14 KM 0.3 INTERIOR
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737-2800
Practice Address - Country:US
Practice Address - Phone:787-530-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty