Healthcare Provider Details

I. General information

NPI: 1275408494
Provider Name (Legal Business Name): SERVICIOS MEDICOS RRG & ASOC PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR.925 KM.0.3 RIO ABAJO MARGINAL JUNQUITO
HUMACAO PR
00791
US

IV. Provider business mailing address

HC 12 BOX 5623
HUMACAO PR
00791-9205
US

V. Phone/Fax

Practice location:
  • Phone: 939-529-8179
  • Fax:
Mailing address:
  • Phone: 939-529-8179
  • Fax:

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 Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMMANUEL RIVERA GONZALEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 939-529-8179