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General NPI Number Information
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NPI Number | 1407270606
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE CANOVANAS GROUP CORP.
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 48 CALLE ORQUIDEA URB LOIZA VALLEY
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City | CANOVANAS
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State | PR
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Zip | 00729-3596
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Country | US
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Telephone | 787-256-0848
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Fax | 787-256-2990
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Provider Business Mailing Address
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Address Line | PO BOX 20000 PMB 121
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-256-0848
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Fax | 787-256-2990
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. LOURDES MERINO
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Credential |
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Telephone | 787-256-0848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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