Provider Demographics
NPI:1730509209
Name:YAMCELY MEDICAL SERVICES CSP
Entity type:Organization
Organization Name:YAMCELY MEDICAL SERVICES CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-824-0050
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-0134
Mailing Address - Country:US
Mailing Address - Phone:787-824-0050
Mailing Address - Fax:787-824-0050
Practice Address - Street 1:BO COCO NUEVO 360
Practice Address - Street 2:CALLE SANTIAGO IGLESIAS
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-0000
Practice Address - Country:US
Practice Address - Phone:787-824-0050
Practice Address - Fax:787-824-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6816261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4307OtherDEPARTAMENTO DE ESTADO