# ANGELORUM INC

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

## Provider details

- **NPI number:** 1750609319
- **Authorized official:** DR. LUIS M GONZALEZ BERMUDEZMD MD (PRESIDENT)
- **Authorized official phone:** (787) 270-4747

## Contact information

- **Practice address:** CARR 693 KM 13.8 SUITE 171 BO BRENAS, VEGA ALTA, PR 00692
- **Practice address phone:** (787) 270-4747
- **Practice address fax:** (787) 270-4747
- **Mailing address:** PO BOX 356, VEGA ALTA, PR 00692-0356
- **Mailing address phone:** (787) 270-4747
- **Mailing address fax:** (787) 270-4747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 57474 | PR | Yes |
| 261QR0200X | Radiology Clinic/Center | 57474 | PR | — |
| 291U00000X | Clinical Medical Laboratory | 57474 | PR | — |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 05/06/2010