Healthcare Provider Details

I. General information

NPI: 1649398116
Provider Name (Legal Business Name): APD MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA # 2 KM 68.1 BO. CERCADILLO
ARECIBO PR
00612
US

IV. Provider business mailing address

1151 CALLE 4 SE CAPARRA TERRACE
SAN JUAN PR
00921-1734
US

V. Phone/Fax

Practice location:
  • Phone: 787-815-3923
  • Fax: 787-283-8711
Mailing address:
  • Phone: 787-243-2984
  • Fax: 787-283-8711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEJANDRA THOMAS VISSEPO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-243-2984