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General NPI Number Information
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NPI Number | 1275080079
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Entity Type | Organization
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Legal Business Name | GGR MEDICAL SERVICES, INC.
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 159 CALLE LUIS MUNOZ RIVERA
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-559-1875
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Fax | 787-937-7883
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Provider Business Mailing Address
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Address Line | 159 CALLE LUIS MUNOZ RIVERA
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-559-1875
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Fax | 787-937-7883
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GRISELLE GERENA
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Credential | M.D.
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Telephone | 787-559-1875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 15198
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License Number State | PR
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