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NPI Code Detail

MEDICARE: GRUPO MEDICO SUR-MED

MEDICARE: GRUPO MEDICO SUR-MED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1588970131
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRUPO MEDICO SUR-MED
Provider Business Mailing Address
First Line : PO BOX 1162
Second Line :
City : SALINAS
State : PR
Zip : 00751-1162
Country : US
Telephone Number : 787-824-1100
Fax Number : 787-824-7655
Provider Business Practice Location Address
First Line : 8 CALLE COLON PACHECO
Second Line :
City : SALINAS
State : PR
Zip : 00751-3344
Country : US
Telephone Number : 787-824-1100
Fax Number : 787-824-7655
Authorized Official
Title or Position : OFFICER
Name : ANGEL C REYES VARGAS
Credential : M.D., J.D.
Telephone Number : 787-824-1100
Provider Enumeration Date : 08/20/2010
Last Update Date : 08/20/2010

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Directions to “GRUPO MEDICO SUR-MED ” Practice Location

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