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General NPI Number Information
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NPI Number | 1992626121
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Entity Type | Organization
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Legal Business Name | MGDP INFECTOLOGIST LLC
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 600 CARR 2 STE 6
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City | MANATI
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State | PR
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Zip | 00674-5399
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Country | US
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Telephone | 787-612-6334
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CARR 2 STE 6
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City | MANATI
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State | PR
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Zip | 00674-5399
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Country | US
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Telephone | 787-612-6334
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Fax |
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Authorized Official
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Title or Position | INFECTOLOGIST
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Name | MARIE GLORIA DIAZ
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Credential | MD
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Telephone | 787-612-6334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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