Organization
GOLD STAR MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHID M CHAUDHARY MD (MEDICAL DIRECTOR)
(787) 673-1238
Entity
Organization
Contact information
Practice address
2 AVE LUIS MUNOZ MARIN, HORMIGUEROS, PR 00660-1750
(787) 673-1238
Mailing address
#184 CALLE VALENCIA, URB. LA SALAMANCA, SAN GERMAN, PR 00683
(787) 673-1238
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371248
REGISTER NUMBER
PR
Enumeration date
08/20/2021
Last updated
09/11/2023
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