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General NPI Number Information
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NPI Number | 1235836487
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Entity Type | Organization
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Legal Business Name | MPM LLC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 1451 AVE ASHFORD
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City | SAN JUAN
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State | PR
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Zip | 00907-1511
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Country | US
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Telephone | 787-603-2404
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20004
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City | SAN JUAN
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State | PR
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Zip | 00928-0004
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Country | US
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Telephone | 787-603-2404
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. MARIA DEL PILAR MATTA GONZALEZ
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Credential | MD
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Telephone | 787-593-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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