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Organization
GRUPO SAN MATEO, LLC
Active
Organization
GRUPO SAN MATEO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASCO EGUIA MD (PRESIDENT OWNER)
(787) 633-5263
Entity
Organization
Contact information
Practice address
1607 AVE PONCE DE LEON STE GM04, SAN JUAN, PR 00909-1803
(787) 910-0909
(888) 588-0319
Mailing address
1353 AVE LUIS VIGOREAUX PMB 757, GUAYNABO, PR 00966-2715
(787) 633-5263
(888) 588-0319
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
NULL
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
NULL
2080P0206X
Pediatric Gastroenterology Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
Other
Enumeration date
03/12/2019
Last updated
03/15/2023
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