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General NPI Number Information
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NPI Number | 1528386190
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Entity Type | Organization
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Legal Business Name | LAS LOMAS MEDICAL GROUP CSP
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 10/09/2013
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Provider Practice Location Address
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Address Line | CARRETERA 21 U3 -3
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City | RIO PIEDRAS
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State | PR
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Zip | 00921-0000
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Country | US
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Telephone | 787-783-6460
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Fax | 787-792-0018
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Provider Business Mailing Address
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Address Line | CARRETERA 21 U3 -3
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City | RIO PIEDRAS
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State | PR
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Zip | 00921-0000
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Country | US
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Telephone | 787-783-6460
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Fax | 787-792-0018
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR A APONTE
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Credential | MD
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Telephone | 787-783-6460
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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 | 9284
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License Number State | PR
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