=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518464825
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMPRESAS MPF, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2018
-----------------------------------------------------
Last Update Date | 02/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35A CALLE GEORGETTI STE 2
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725-3946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-665-4320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35A CALLE GEORGETTI STE 2
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725-3946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-665-4320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. FRANCISCO GABRIEL GOMEZ AVILES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 229-944-0242
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------