Provider Demographics
NPI:1285975813
Name:MEDICAL OFFICE HEALTH SERVICES PSC
Entity type:Organization
Organization Name:MEDICAL OFFICE HEALTH SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DE LOS ANGELES
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-415-7514
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-0903
Mailing Address - Country:US
Mailing Address - Phone:787-895-0914
Mailing Address - Fax:787-895-6945
Practice Address - Street 1:BO TERRANOVA CALLE MARGONAL DEL PARQUE
Practice Address - Street 2:CARR #2 KM 101.6
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-0903
Practice Address - Country:US
Practice Address - Phone:787-895-0914
Practice Address - Fax:787-895-6945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR011789261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center