# CAPARRA INTERNAL MEDICINE SERVICE GROUP PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CAPARRA INTERNAL MEDICINE SERVICE GROUP PSC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093727026
- **Authorized official:** MR. DAVID MATTA- FONTANET (SUPERVISOR)
- **Authorized official phone:** (787) 801-4025

## Contact information

- **Practice address:** 390 CALLE GARDENIA, LA PONDEROSA, RIO GRANDE, PR 00745-2201
- **Practice address phone:** (787) 809-4025
- **Practice address fax:** (787) 809-3424
- **Mailing address:** 390 CALLE GARDENIA, LA PONDEROSA, RIO GRANDE, PR 00745-2201
- **Mailing address phone:** (787) 809-4025
- **Mailing address fax:** (787) 809-3424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 13484 | PR | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 02/25/2011