| De Soto Internal Medicine Services, Psc | |
|
Calle Flor Gerena 13 Humacao PR 00791 | |
| (787) 518-0104 | |
| Not Available |
| Full Name | De Soto Internal Medicine Services, Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | Calle Flor Gerena 13, Humacao, Puerto Rico |
| Authorized Official Name and Position | Francisco R Carballo Duran (PROVIDER) |
| Authorized Official Contact | 7875180104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| De Soto Internal Medicine Services, Psc 185 Candelero Dr Apt 608 Fairlakes Village Humacao PR 00791-6133 Ph: (787) 518-0104 | De Soto Internal Medicine Services, Psc Calle Flor Gerena 13 Humacao PR 00791 Ph: (787) 518-0104 |
| NPI Number | 1568430585 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 12/02/2010 |
| Medicare PECOS PAC ID | 4789872136 |
|---|---|
| Medicare Enrollment ID | O20101229000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568430585 | NPI | - | NPPES |
| 84851DE | Other | PR | TRIPLE S |
| P070 | Other | PR | FIRST MEDICAL |
| 212353 | Other | PR | PREFERRED HEALTH |
| 4069 | Other | PR | UHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 8260 (Puerto Rico) | Primary |
| Provider Name | Francisco R Carballo Duran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174591093 PECOS PAC ID: 6709821143 Enrollment ID: I20050625000000 |
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