Provider Demographics
NPI:1710256292
Name:INTEGRATED EMEGENCY MEDICAL SERVICES & MANAGEMENT
Entity Type:Organization
Organization Name:INTEGRATED EMEGENCY MEDICAL SERVICES & MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRON MAZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-285-2553
Mailing Address - Street 1:CALLE JORGE FRANCESCHI #10
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-0000
Mailing Address - Country:US
Mailing Address - Phone:787-285-6552
Mailing Address - Fax:787-285-6541
Practice Address - Street 1:CALLE JORGE FRANCESCHI #10
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-0000
Practice Address - Country:US
Practice Address - Phone:787-285-6552
Practice Address - Fax:787-285-6541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty