Healthcare Provider Details

I. General information

NPI: 1083984926
Provider Name (Legal Business Name): GRUPO MEDICO SALA DE EMERGENCIA DR.LOPEZ ANTONGIORGI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUERTO NUEVO 25NE STREET #333
SAN JUAN PR
00928
US

IV. Provider business mailing address

PUERTO NUEVO 25NE STREET #333
SAN JUAN PR
00928
US

V. Phone/Fax

Practice location:
  • Phone: 787-480-3841
  • Fax: 787-977-0544
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VEGA MARITZA
Title or Position: EXECUTIVE SUB-DIRECTOR
Credential: MBA HCM
Phone: 787-480-3842