# MMC MED GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457916256
- **Authorized official:** JUAN COLON MD (MBR)
- **Authorized official phone:** (787) 804-0399

## Contact information

- **Practice address:** MAYAGUEZ MEDICAL CENTER, HOSTOS AVE RD \#2 1ST FLOOR STE 103, MAYAGUEZ, PR 00680
- **Practice address phone:** (787) 652-9200
- **Mailing address:** PO BOX 1179, SABANA GRANDE, PR 00637
- **Mailing address phone:** (787) 804-0399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2019
- **Last updated:** 05/07/2019