Provider Demographics
NPI:1285948182
Name:MU MEDICOS UNIDOS DE PUERTO RICO INC
Entity type:Organization
Organization Name:MU MEDICOS UNIDOS DE PUERTO RICO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-717-5655
Mailing Address - Street 1:25 CALLE LEPANTO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1905
Mailing Address - Country:US
Mailing Address - Phone:787-717-5655
Mailing Address - Fax:787-282-0238
Practice Address - Street 1:25 CALLE LEPANTO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-1905
Practice Address - Country:US
Practice Address - Phone:787-717-5655
Practice Address - Fax:787-282-0238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service