| Dmra Llc | |
|
65 De Infanteria #67 Suite 104-109 Anasco PR 00610 | |
| (787) 826-2145 | |
| (787) 826-7411 |
| Full Name | Dmra Llc |
|---|---|
| Speciality | General Practice |
| Location | 65 De Infanteria #67, Anasco, Puerto Rico |
| Authorized Official Name and Position | Roberto J Ayala Rios (PRESIDENT) |
| Authorized Official Contact | 7873706187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmra Llc Po Box 1750 Anasco PR 00610-1750 Ph: (787) 342-4880 | Dmra Llc 65 De Infanteria #67 Suite 104-109 Anasco PR 00610 Ph: (787) 826-2145 |
| NPI Number | 1245508282 |
|---|---|
| Provider Enumeration Date | 12/05/2011 |
| Last Update Date | 09/15/2014 |
| Medicare PECOS PAC ID | 4385884121 |
|---|---|
| Medicare Enrollment ID | O20130628000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245508282 | NPI | - | NPPES |
| 100686 | Other | PR | MMM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 17640 (Puerto Rico) | Primary |
| Provider Name | Diahnara Mercado Ramirez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043208432 PECOS PAC ID: 9234156712 Enrollment ID: I20051025000495 |
| Provider Name | Roberto J Ayala Rios |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518197136 PECOS PAC ID: 8527246859 Enrollment ID: I20110708000520 |
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