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General NPI Number Information
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NPI Number | 1679994024
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Entity Type | Organization
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Legal Business Name | HG MEDICAL SERVICES PSC
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Dates
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Enumeration Date | 01/02/2014
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Last Update Date | 01/02/2014
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Provider Practice Location Address
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Address Line | TORRE MEDICA AUXILIO MUTUO SUITE 413
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City | SAN JUAN
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State | PR
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Zip | 00917
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Country | US
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Telephone | 787-767-7885
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Fax | 787-767-5626
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Provider Business Mailing Address
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Address Line | PO BOX 1969
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City | GUAYNABO
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State | PR
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Zip | 00970-1967
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Country | US
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Telephone | 787-767-7885
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Fax | 787-767-5626
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Authorized Official
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Title or Position | PRESIDENT/MD
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Name | MARIO A. HADDAD
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Credential | M.D.
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Telephone | 787-767-7885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9042
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License Number State | PR
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