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General NPI Number Information
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NPI Number | 1366432783
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Entity Type | Organization
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Legal Business Name | GRUPO DE SERVICIOS GERIATRICO
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 488 CARR 845 URB PURPLE TREE
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City | SAN JUAN
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State | PR
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Zip | 00926-4403
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Country | US
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Telephone | 787-761-1945
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Fax | 787-761-1947
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Provider Business Mailing Address
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Address Line | 488 CARR 845 URB PURPLE TREE
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City | SAN JUAN
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State | PR
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Zip | 00926-4403
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Country | US
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Telephone | 787-761-1945
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Fax | 787-761-1947
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | MRS. CARMEN MILAGROS MARRERO
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Credential | M. D.
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Telephone | 787-761-1943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9548
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 9548
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License Number State | PR
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