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General NPI Number Information
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NPI Number | 1003953621
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Entity Type | Organization
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Legal Business Name | M & B INTERNAL MEDICINE GROUP P S C
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 16 NORTE PERAL 1 A EDIFICIO TORRE PERAL
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City | MAYAGUEZ
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State | PR
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Zip | 00680-0000
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Country | US
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Telephone | 787-834-6825
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Fax | 787-834-6865
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Provider Business Mailing Address
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Address Line | PO BOX 1478
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City | MAYAGUEZ
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State | PR
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Zip | 00681-1478
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Country | US
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Telephone | 787-834-6825
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Fax | 787-834-6865
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Authorized Official
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Title or Position | PROPIETARIA
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Name | DR. CARRIE C BACO BROGNIEZ
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Credential | MD
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Telephone | 787-834-6825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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