Samba Bras Medical, P.S.C

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

11782 Issued in PR

Legal business name

SAMBA BRAS MEDICAL, P.S.C

Practice address

Ave. General Valero 410
Torre Medica San Pablo Oficina 409
Fajardo, PR 00738

Phone

(787) 863-3636

Fax

(787) 863-3638

NPI assigned

Mar 24, 2010

Last updated

Mar 29, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jamil Abou El Hossen Duarte, M.D

Title

Presidente

Phone

(787) 863-3636

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jamil Abouelhossen, MD

  • Internal Medicine Physician
  • Fajardo, PR
  • NPI 1356347538
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1588988216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 823",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007380823",
            "telephone_number": "787-863-3636",
            "fax_number": "787-863-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. GENERAL VALERO 410",
            "address_2": "TORRE MEDICA SAN PABLO OFICINA 409",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-863-3636",
            "fax_number": "787-863-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMBA BRAS MEDICAL, P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "ABOU EL HOSSEN DUARTE",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-863-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "PR",
            "license": "11782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Eduardo Ruiz
• S.M Medical Services, C.S.P.
• Luis Raul Salaman Marin, MD.
• Jesus Del Socorro Salamo, MA
• Salud Integral de Individuos Y Familias, LLC
• Ana Lucia Sanchez Ferreras, MD
• Angel Sanchez, M.D.
• Jaime R. Sanchez I, M.D.
• Jorge Enrique Sanchez, MD
• Aurea Santiago III, LCSW

• Health Maintenance Organization in Fajardo, PR
• Providers in Fajardo, PR by specialty
• Health Maintenance Organization in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.