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General NPI Number Information
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NPI Number | 1679606065
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Entity Type | Organization
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Legal Business Name | SAMARITAN MEDICAL GROUP 7, PSC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | PMB 467 200 AVE RAFAEL CORDERO SUITE 140
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-484-2396
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 467 200 AVE RAFAEL CORDERO SUITE 140
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-484-2396
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOHN E HYLER
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Credential |
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Telephone | 787-484-2396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PR
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