Provider Demographics
NPI:1972659720
Name:COMPLETE INTERNAL MEDICINE SERVICES,PSC
Entity Type:Organization
Organization Name:COMPLETE INTERNAL MEDICINE SERVICES,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-744-1863
Mailing Address - Street 1:PMB 471 SUITE 140
Mailing Address - Street 2:200 AVE RAFAEL CORDERO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3757
Mailing Address - Country:US
Mailing Address - Phone:787-744-1863
Mailing Address - Fax:
Practice Address - Street 1:130A PRIMER PISO HOSPITAL HIMA SAN PABLO
Practice Address - Street 2:AVE MUNOZ MARIN
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-1863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2407OtherPREFERRED MEDICARE CHOICE
PR2407OtherPREFERRED MEDICARE CHOICE