Provider Demographics
NPI:1760281158
Name:MEDICO POR AMOR, LLC
Entity type:Organization
Organization Name:MEDICO POR AMOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICDIA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:SOSTRE CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-474-7657
Mailing Address - Street 1:PO BOX 1055
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-1055
Mailing Address - Country:US
Mailing Address - Phone:321-474-7657
Mailing Address - Fax:
Practice Address - Street 1:CARR 115 KM 7.4
Practice Address - Street 2:BARRIO CAGUABO
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:321-474-7657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center