Healthcare Provider Details

I. General information

NPI: 1124350574
Provider Name (Legal Business Name): MORGAR CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROBERTO CLEMENTE AVE STREET 76 114 #4
CAROLINA PR
00983
US

IV. Provider business mailing address

PO BOX 11665
SAN JUAN PR
00910
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-1616
  • Fax: 787-727-6224
Mailing address:
  • Phone: 787-641-1616
  • Fax: 787-727-6224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number10647
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number11116
License Number StatePR

VIII. Authorized Official

Name: DR. LOURDES GARCIA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-641-1616