| Kcm Service, Psc | |
|
Bayamon Plaza Suite 503 Bayamon PR 00959-0095 | |
| (787) 787-9315 | |
| (787) 787-9315 |
| Full Name | Kcm Service, Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | Bayamon Plaza, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Carlos J. Miranda (PRESIDENT) |
| Authorized Official Contact | 7877879315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kcm Service, Psc Po Box 16843 San Juan PR 00908-6843 Ph: (787) 787-9315 | Kcm Service, Psc Bayamon Plaza Suite 503 Bayamon PR 00959-0095 Ph: (787) 787-9315 |
| NPI Number | 1376065037 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 07/13/2017 |
| Medicare PECOS PAC ID | 3274898093 |
|---|---|
| Medicare Enrollment ID | O20180529001774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376065037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Carlos J Miranda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902914880 PECOS PAC ID: 8426218561 Enrollment ID: I20120327000418 |
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