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General NPI Number Information
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NPI Number | 1124790944
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Entity Type | Organization
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Legal Business Name | MG GALENUS LLC
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | DE DIEGO AVE. #150
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 939-274-7336
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Fax |
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Provider Business Mailing Address
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Address Line | 100 RAMON LUIS RIVERA AVENUE BOX 8989
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELLE S AVILES
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Credential | MD
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Telephone | 939-274-7336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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