Provider Demographics
NPI:1801979315
Name:SOCIEDAD MOROVENA DE SERVICIOS DE SALUD (SOMOSS, INC)
Entity type:Organization
Organization Name:SOCIEDAD MOROVENA DE SERVICIOS DE SALUD (SOMOSS, INC)
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-862-4417
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-0934
Mailing Address - Country:US
Mailing Address - Phone:787-862-3035
Mailing Address - Fax:
Practice Address - Street 1:AVE. BUENA VISTA 5
Practice Address - Street 2:SUITE 1
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:787-862-3035
Practice Address - Fax:787-862-3035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1-7060 OFOtherTRIPLE S PROVIDER NUMBER