| Smm Healthcare Provider Llc | |
|
1507 Ave Ponce De Leon San Juan PR 00909-1750 | |
| (939) 475-1414 | |
| (939) 475-1422 |
| Full Name | Smm Healthcare Provider Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1507 Ave Ponce De Leon, San Juan, Puerto Rico |
| Authorized Official Name and Position | Sylmarie Marrero Martinez (SOLE PROPRIETOR) |
| Authorized Official Contact | 7874120002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smm Healthcare Provider Llc Po Box 215 Humacao PR 00792-0215 Ph: (787) 412-0002 | Smm Healthcare Provider Llc 1507 Ave Ponce De Leon San Juan PR 00909-1750 Ph: (939) 475-1414 |
| NPI Number | 1821778689 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 5294187118 |
|---|---|
| Medicare Enrollment ID | O20240116004427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821778689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sylmarie M Marrero Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245475938 PECOS PAC ID: 2567613854 Enrollment ID: I20121114000359 |
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