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General NPI Number Information
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NPI Number | 1417439258
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Entity Type | Organization
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Legal Business Name | ROYAL MEDICAL GROUP LLC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | ESTANCIAS DE LOS ARTESANOS G5 CALLE CERAMICA
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-940-4086
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 9904
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City | JUNCOS
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State | PR
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Zip | 00777-9848
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Country | US
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Telephone | 787-940-4086
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | YANITZA GARCIA
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Credential |
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Telephone | 787-940-4086
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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 |
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License Number State | PR
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