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General NPI Number Information
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NPI Number | 1528667821
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Entity Type | Organization
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Legal Business Name | QUALITY GASTROENTEROLOGY LLC
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | CARR 181 KM 2.1
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City | TRUJILLO ALTO
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-347-5611
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Fax | 866-912-2620
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Provider Business Mailing Address
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Address Line | MONTEHIEDRA 211 ZORZAL
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City | SAN JUA
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-347-5611
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FERNANDO BAEZ
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Credential | MD
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Telephone | 787-347-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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