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General NPI Number Information
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NPI Number | 1285692236
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Entity Type | Organization
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Legal Business Name | JUANA DIAZ MEDICAL GROUP INC
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 03/13/2009
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Provider Practice Location Address
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Address Line | CALLE DEGETAU ESQUINA MUNOZ RIVERA #45
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City | JUANA DIAZ
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State | PR
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Zip | 00795-0378
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Country | US
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Telephone | 787-837-3530
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Fax | 787-837-3382
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Provider Business Mailing Address
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Address Line | PO BOX 378
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City | JUANA DIAZ
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State | PR
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Zip | 00795-0378
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Country | US
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Telephone | 787-837-3530
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Fax | 787-837-3382
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. MARIA TERESA GARCIA
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Credential | M.D
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Telephone | 787-837-3530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 5253
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License Number State | PR
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