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General NPI Number Information
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NPI Number | 1487865382
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Entity Type | Organization
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Legal Business Name | MEDICINA INTEGRAL Y PREVENTIVA INC.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | PLAZA CONSTANCIA PISO 2 CARR. #2
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City | HORMIGUEROS
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State | PR
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Zip | 00660
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Country | US
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Telephone | 787-849-3845
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Fax | 787-849-3845
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Provider Business Mailing Address
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Address Line | PMB 154 P.O.BOX 5103
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City | CABO ROJO
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State | PR
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Zip | 00623
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Country | US
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Telephone | 787-849-3845
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Fax | 787-849-3845
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Authorized Official
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Title or Position | MEDICINE DOCTOR
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Name | DR. GUILLERMO PAGAN CALO
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Credential | M.D.
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Telephone | 787-849-3845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14386
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License Number State | PR
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