Healthcare Provider Details

I. General information

NPI: 1750454526
Provider Name (Legal Business Name): PUERTO RICO HEALTH CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8169 CALLE CONCORDIA SUITE 312 CONDOMINIO SAN VICENTE
PONCE PR
00717-1563
US

IV. Provider business mailing address

8169 CALLE CONCORDIA SUITE 312 CONDOMINIO SAN VICENTE
PONCE PR
00717-1563
US

V. Phone/Fax

Practice location:
  • Phone: 787-841-2777
  • Fax: 787-848-0007
Mailing address:
  • Phone: 787-841-2777
  • Fax: 787-848-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: SERGIO R LOPEZ DEL POZO
Title or Position: DIRECTOR MEDICO
Credential: MD
Phone: 787-841-2777