Healthcare Provider Details

I. General information

NPI: 1922976687
Provider Name (Legal Business Name): GR MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 6
BARCELONETA PR
00617-0006
US

IV. Provider business mailing address

5 AVE CAMINO DEL SOL
VEGA BAJA PR
00693-4163
US

V. Phone/Fax

Practice location:
  • Phone: 939-460-1401
  • Fax:
Mailing address:
  • Phone: 939-460-1401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ANGEL G GUERRERO
Title or Position: PRESIDENT
Credential: MD, MHSA
Phone: 939-460-1401