Provider Demographics
NPI:1154777043
Name:EDIMIL ENDOCRINOLOGY SERVICES, PSC
Entity type:Organization
Organization Name:EDIMIL ENDOCRINOLOGY SERVICES, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ENDOCRINOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-307-9977
Mailing Address - Street 1:PO BOX 915
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-0915
Mailing Address - Country:US
Mailing Address - Phone:787-307-9977
Mailing Address - Fax:
Practice Address - Street 1:2 COND VILLAS DE CAGUAS REAL 233
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-9999
Practice Address - Country:US
Practice Address - Phone:787-307-9977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18113261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center