Provider Demographics
NPI:1285948034
Name:RED INTEGRADA DE MEDICOS DEL SUR INC.
Entity type:Organization
Organization Name:RED INTEGRADA DE MEDICOS DEL SUR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-842-8945
Mailing Address - Street 1:AVE. LAS AMERICAS
Mailing Address - Street 2:2015 SUITE 101
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0726
Mailing Address - Country:US
Mailing Address - Phone:787-842-8945
Mailing Address - Fax:
Practice Address - Street 1:AVE. LAS AMERICAS
Practice Address - Street 2:2015 SUITE 101
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0726
Practice Address - Country:US
Practice Address - Phone:787-842-8945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29745Medicare PIN