Provider Demographics
NPI:1932585270
Name:MARLIZ MEDICAL SERVICES P.S.C.
Entity Type:Organization
Organization Name:MARLIZ MEDICAL SERVICES P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORCHADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-872-8313
Mailing Address - Street 1:PO BOX 1039
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-1039
Mailing Address - Country:US
Mailing Address - Phone:787-872-8313
Mailing Address - Fax:787-872-8313
Practice Address - Street 1:7260 AVE AGUSTIN RAMOS CALERO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-872-8313
Practice Address - Fax:787-872-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12847302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1750376406Medicare PIN
PRH67641Medicare UPIN
PR1750376406Medicare Oscar/Certification