Provider Demographics
NPI:1780096511
Name:DERM SOLUTIONS LLC
Entity type:Organization
Organization Name:DERM SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEIJO-MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-626-3431
Mailing Address - Street 1:PO BOX 364171
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4171
Mailing Address - Country:US
Mailing Address - Phone:787-626-3431
Mailing Address - Fax:787-626-5163
Practice Address - Street 1:JOSE GARRIDO AVE SUITE 209
Practice Address - Street 2:CATALINAS CINEMA BUILDING
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-626-3431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18053261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty