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General NPI Number Information
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NPI Number | 1558009142
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Entity Type | Organization
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Legal Business Name | PHYSICIANS HEALTH GROUP L.L.C.
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 126 CALLE PAVIA FERNANDEZ OFICINA 201
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-2285
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Country | US
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Telephone | 787-233-0868
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 609
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-0609
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Country | US
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Telephone | 787-546-1532
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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. JUAN LUIS ROBLES NIEVES
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Credential | MD
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Telephone | 787-546-1532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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