Healthcare Provider Details

I. General information

NPI: 1528814399
Provider Name (Legal Business Name): METRO MAYAGUEZ INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CALLE DR BASORA N
MAYAGUEZ PR
00680-4833
US

IV. Provider business mailing address

PO BOX 170
MAYAGUEZ PR
00681-0170
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-0101
  • Fax: 787-805-0232
Mailing address:
  • Phone: 787-834-0101
  • Fax: 787-805-0232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOANNIE GARCIA
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 787-834-0101