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General NPI Number Information
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NPI Number | 1487950051
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Entity Type | Organization
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Legal Business Name | FMG CARE MANAGEMENT COORDINATOR INC.
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | ROBERTO CLEMENTE AVE. BLQ 124 NO. 8
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City | CAROLINA
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State | PR
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Zip | 00985-0000
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Country | US
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Telephone | 787-257-0709
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3628
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City | CAROLINA
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State | PR
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Zip | 00984-3628
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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 | ADMINISTRATOR
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Name | JORGE F HESS
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Credential | M.D.
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Telephone | 787-257-0709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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