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General NPI Number Information
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NPI Number | 1144568098
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Entity Type | Organization
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Legal Business Name | AGM-GE,LLC
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | J23 CALLE ELLIOT VELEZ URB ATENAS
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City | MANATI
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State | PR
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Zip | 00674-4616
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Country | US
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Telephone | 787-854-0404
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Fax | 787-854-0403
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Provider Business Mailing Address
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Address Line | 33 CALLE AMBER TREASURE POINT
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City | VEGA ALTA
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State | PR
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Zip | 00692-8917
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Country | US
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Telephone | 787-449-2201
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Fax | 787-854-0403
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. AILEEN GUZMAN
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Credential | M.D.
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Telephone | 787-449-2201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 13604
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License Number State | PR
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