Provider Demographics
NPI:1750638839
Name:PREVENTIVE MEDICAL CARE SERVICES, PSC
Entity Type:Organization
Organization Name:PREVENTIVE MEDICAL CARE SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MUNTANER-MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-487-2194
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-1001
Mailing Address - Country:US
Mailing Address - Phone:787-885-4446
Mailing Address - Fax:
Practice Address - Street 1:205 AVE LAURO PINERO
Practice Address - Street 2:
Practice Address - City:CEIBA
Practice Address - State:PR
Practice Address - Zip Code:00735-2701
Practice Address - Country:US
Practice Address - Phone:787-885-4446
Practice Address - Fax:787-885-6129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service