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General NPI Number Information
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NPI Number | 1093589632
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Entity Type | Organization
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Legal Business Name | MC MEDICAL CLINIC
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 90 CALLE ALONDRA PLAZA 65 SHOPPING CENTER
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 939-257-6274
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Fax |
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Provider Business Mailing Address
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Address Line | 932 BECASINA ST CONTRY CLUB
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 939-257-6274
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUAN MONTOYO SANTIAGO
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Credential | MD
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Telephone | 939-257-6274
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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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