Provider Demographics
NPI:1972911816
Name:BKE MEDICAL SERVICES PSC
Entity Type:Organization
Organization Name:BKE MEDICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YONATHAN
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-392-9772
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0359
Mailing Address - Country:US
Mailing Address - Phone:787-392-9772
Mailing Address - Fax:787-846-5458
Practice Address - Street 1:PASEO 81 URB. VILLA PINARES
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-392-9772
Practice Address - Fax:787-846-5458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care