Provider Demographics
NPI:1750428884
Name:INDEPENDENT MEDICAL SERVICES
Entity type:Organization
Organization Name:INDEPENDENT MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ARMANDO
Authorized Official - Last Name:ARRAUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-889-2267
Mailing Address - Street 1:PO BOX 1311
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1311
Mailing Address - Country:US
Mailing Address - Phone:787-889-2267
Mailing Address - Fax:787-889-2267
Practice Address - Street 1:AVE. PRINCIPAL G-5 URB. BARALT
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-889-2267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11863174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty