Provider Demographics
NPI:1811206154
Name:WEST MEDICAL INTEGRATED SERVICES, PSC
Entity Type:Organization
Organization Name:WEST MEDICAL INTEGRATED SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-479-7767
Mailing Address - Street 1:PMB 72 BOX 1503
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-479-7767
Mailing Address - Fax:787-254-1920
Practice Address - Street 1:CARR 101 KM 16.2
Practice Address - Street 2:LAS ARENAS
Practice Address - City:BOQUERON
Practice Address - State:PR
Practice Address - Zip Code:00622
Practice Address - Country:US
Practice Address - Phone:787-255-2775
Practice Address - Fax:787-254-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15181208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty