Healthcare Provider Details

I. General information

NPI: 1790606549
Provider Name (Legal Business Name): YRG MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RIO GRANDE ST 4 R MARGARITA 12253
RIO GRANDE PR
00745
US

IV. Provider business mailing address

RIO GRANDE ST 4 R MARGARITA 12253
RIO GRANDE PR
00745
US

V. Phone/Fax

Practice location:
  • Phone: 787-459-4072
  • Fax:
Mailing address:
  • Phone: 787-459-4072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: YESSENIA ROSADO FONZALEZ
Title or Position: PRESIDENT
Credential: DMD
Phone: 787-459-4072