MEDICARE: GRUPO MEDICO NEW CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician		PR
2	207RC0000X	Cardiovascular Disease Physician		PR
3	208D00000X	General Practice Physician	15268	PR

General Provider Information

NPI Number	:	1073797817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRUPO MEDICO NEW CARE

Provider Business Mailing Address
First Line	:	525 PARQ CENTRAL
Second Line	:	CALLE S CUEVAS BUSTAMANTE
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2642
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 PARQ CENTRAL
Second Line	:	CALLE S CUEVAS BUSTAMANTE
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2642
Country	:	US
Telephone Number	:	787-614-9285
Fax Number	:

Authorized Official
Title or Position	:	DELEGATE OFFICIAL
Name	:	ANNETTE ROMAN
Credential	:	D.O
Telephone Number	:	787-614-9285

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	01/07/2014

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Directions to “GRUPO MEDICO NEW CARE ” Practice Location

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