Organization
PHYSICIANS AT HOME
Active
Other names
MD AT HOME
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DE GRACIA (PRESIDENT)
(787) 479-6620
Entity
Organization
Contact information
Practice address
300 BLVD DE LA MONTANA, APT 655, SAN JUAN, PR 00926-7027
(787) 479-6620
Mailing address
16034 BOLT DR, CANOVANAS, PR 00729-3801
(787) 479-6620
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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