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General NPI Number Information
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NPI Number | 1215459813
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Entity Type | Organization
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Legal Business Name | PR HEALTHCARE MANAGEMENT GROUP
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | CARR 31 KM 4.0 NAGUABO MEDICAL MALL
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City | NAGUABO
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State | PR
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Zip | 00718
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Country | US
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Telephone | 787-874-1825
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Fax | 787-874-3125
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Provider Business Mailing Address
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Address Line | PO BOX 2598
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City | GUAYNABO
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State | PR
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Zip | 00970-2598
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Country | US
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Telephone | 787-637-6274
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Fax | 787-874-3125
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARRY EMILIO NEGRON JUDICE
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Credential | MD
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Telephone | 787-637-6274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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