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General NPI Number Information
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NPI Number | 1841806742
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Entity Type | Organization
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Legal Business Name | NEX-GEN MEDICAL SERVICES P S C
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | CARR 107 KM 2.9 BO. BORINQUEN
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City | AGUADILLA
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State | PR
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Zip | 00603-0060
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Country | US
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Telephone | 787-891-7428
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Fax |
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Provider Business Mailing Address
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Address Line | VILLAS UNIVERSITARIAS UPR 64
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 787-360-0610
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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. MODESTO GONZALEZ
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Credential | MD
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Telephone | 787-360-0610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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