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Organization
COSTA ESTE MEDICAL SERVICES LLC
Active
Organization
COSTA ESTE MEDICAL SERVICES LLC
Active
Other names
COSTA ESTE MEDICAL SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ISMARY M GONZALEZ DO (PRESIDENT)
(787) 646-7769
Entity
Organization
Contact information
Practice address
AVE PRINCIPAL F4, URB BARALT, FAJARDO, PR 00738
(787) 860-3700
(787) 860-3800
Mailing address
PO BOX 1001, LUQUILLO, PR 00773-1001
(787) 860-3700
(787) 860-3800
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
NULL
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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