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General NPI Number Information
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NPI Number | 1841454998
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Entity Type | Organization
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Legal Business Name | UNIVERSAL & PROFESIONAL MEDICAL GROUP
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | CAROLINA SHOPP CTR 24-63 AVENUE:ROBERTO CLEMENTE
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City | CAROLINA
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State | PR
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Zip | 00985-5672
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Country | US
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Telephone | 787-403-0237
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Fax | 787-946-3517
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Provider Business Mailing Address
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Address Line | 24-63 AVENUE: ROBERTO CLEMENTE
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-403-0237
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NATACHA SOMOZA
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Credential | TERAPEUTA DEL MASAJE
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Telephone | 787-403-0237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number |
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License Number State | PR
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