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General NPI Number Information
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NPI Number | 1073839890
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Entity Type | Organization
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Legal Business Name | ARQUE-MED
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | AVE. AMERICO MIRANDA #332 VILLA NEVAREZ
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-751-5995
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Fax | 787-751-5995
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Provider Business Mailing Address
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Address Line | AVE. AMERICO MIRANDA #332 VILLA NEVAREZ
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-751-5995
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Fax | 787-751-5995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ISMAEL GUSTAVO CUEVAS
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Credential | M.D.
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Telephone | 787-751-5995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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