Provider Demographics
NPI:1346072915
Name:SALUD INTEGRAL EN LA MONTANA, INC
Entity type:Organization
Organization Name:SALUD INTEGRAL EN LA MONTANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA DEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:AMADOR FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DRA
Authorized Official - Phone:787-869-5900
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0515
Mailing Address - Country:US
Mailing Address - Phone:787-869-5900
Mailing Address - Fax:787-227-1441
Practice Address - Street 1:CARR 159 KM 13.9
Practice Address - Street 2:BO. PUEBLO
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-859-2560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center