Healthcare Provider Details
I. General information
NPI: 1700126109
Provider Name (Legal Business Name): SOLUTION MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2013
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11 AVE SIMON MADERA
SAN JUAN PR
00924-2231
US
IV. Provider business mailing address
HACIENDA SAN JOSE VIA HERMITA STREET # 781
CAGUAS PR
00725
US
V. Phone/Fax
- Phone: 787-420-4054
- Fax: 787-653-9683
- Phone: 787-420-4054
- Fax: 787-653-9683
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0002X |
| Taxonomy | Emergency Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
REYNALDO
PEZZOTTI
Title or Position: INCORPORADOR
Credential: M.D.
Phone: 787-420-4054