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General NPI Number Information
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NPI Number | 1407769961
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Entity Type | Organization
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Legal Business Name | GRUPO QUIRURGICO SURESTE LLC
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | HOSPITAL MENONITA GUAYAMA SUITE 304
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City | GUAYAMA
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State | PR
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Zip | 00785
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Country | US
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Telephone | 787-686-0135
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Fax |
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Provider Business Mailing Address
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Address Line | PRINCIPE CARLOS T13 QUINTAS REALES
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JOSE EMANUEL GARCIA RIVERA
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Credential | MD
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Telephone | 787-390-9114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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