# LA PLATA MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LA PLATA MEDICAL GROUP
- **Other names:** LA PLATA MEDICAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114186814
- **Legal business name:** LA PLATA MEDICAL GROUP
- **Authorized official:** DR. VICTOR M BURGOS M.D. (PRESIDENT)
- **Authorized official phone:** (787) 870-1272

## Contact information

- **Practice address:** A4 CALLE VILLA MARIA, C/LEOPOLDO DIAZ \#1, TOA ALTA, PR 00953-2301
- **Practice address phone:** (787) 870-1272
- **Mailing address:** PO BOX 716, DORADO, PR 00646-0716
- **Mailing address phone:** (787) 870-1272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 5589 | PR | Yes |

## Other

- **Enumeration date:** 06/06/2008
- **Last updated:** 06/06/2008