Basic Medical Group
Family Medicine in San Juan, PR. Organization (NPI-2).
NPI number1770536799
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1770536799
- Entity type
- Organization (NPI-2)
- Legal business name
- Basic Medical Group
- Organization subpart
- No
- Enumeration date
- May 19, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 6366 | PR | Yes |
Practice location
402 Ave Munoz RiveraSan Juan, PR 00918-3310
Phone 787-754-8612
Mailing address
Po Box 191060San Juan, PR 00919-1060
Authorized official
Luz C Castellano
President
7872731227
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