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General NPI Number Information
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NPI Number | 1629682125
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Entity Type | Organization
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Legal Business Name | GRUPO MED
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | FIRST FEDERAL BUILDING SUITE 302 1519 AVE PONCE DE LEON
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-725-8101
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Fax | 787-725-8101
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Provider Business Mailing Address
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Address Line | FIRST FEDERAL BUILDING SUITE 302 1519 AVE PONCE DE LEON
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-725-8101
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Fax | 787-725-8101
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Authorized Official
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Title or Position | PRESIDENTA
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Name | SAMAH ALI SHEHADEH
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Credential | MD
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Telephone | 787-529-3102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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