Provider Demographics
NPI:1457347312
Name:MMS MEDICAL SERVICES GROUP CORP
Entity Type:Organization
Organization Name:MMS MEDICAL SERVICES GROUP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL A
Authorized Official - Middle Name:SANTANA
Authorized Official - Last Name:GROUDONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-276-0400
Mailing Address - Street 1:PO BOX 1233
Mailing Address - Street 2:SAINT JUST STATION
Mailing Address - City:SAINT JUST
Mailing Address - State:PR
Mailing Address - Zip Code:00978-1233
Mailing Address - Country:US
Mailing Address - Phone:787-276-0400
Mailing Address - Fax:787-276-0400
Practice Address - Street 1:CARR 848 KM 3 BO SAN ANTON
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-276-0400
Practice Address - Fax:787-276-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0085025Medicare ID - Type Unspecified