Healthcare Provider Details

I. General information

NPI: 1124594858
Provider Name (Legal Business Name): GALENO'S MEDICAL NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2018
Last Update Date: 10/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B24 CALLE 3
MANATI PR
00674-5409
US

IV. Provider business mailing address

PO BOX 77
MANATI PR
00674-0077
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-3065
  • Fax: 787-854-1687
Mailing address:
  • Phone: 787-884-3065
  • Fax: 787-854-1687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTOR L DELGADO COLON
Title or Position: PRESIDENT
Credential: MD
Phone: 787-884-3065