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General NPI Number Information
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NPI Number | 1871175372
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Entity Type | Organization
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Legal Business Name | MVP HEALTH & MEDICAL GROUP , LLC.
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | CARRETERA 506 KM 1 TORRE SAN CRISTOBAL STE 209
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City | COTO LAUREL
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State | PR
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Zip | 00780
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Country | US
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Telephone | 98-878-7259
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Fax |
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Provider Business Mailing Address
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Address Line | CARRETERA 506 KM 1 TORRE SAN CRISTOBAL STE 209
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City | COTO LAUREL
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State | PR
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Zip | 00780
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Country | US
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Telephone | 98-878-7259
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Fax |
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Authorized Official
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Title or Position | PRESIDENTA
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Name | MIYADY VELAZQUEZ PAGAN
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Credential | PHD
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Telephone | 787-632-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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