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Organization

LA PLATA MEDICAL GROUP

Active
Parent organization
LA PLATA MEDICAL GROUP
Other names
LA PLATA MEDICAL GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
LA PLATA MEDICAL GROUP
Authorized official
DR. VICTOR M BURGOS M.D. (PRESIDENT)
(787) 870-1272
Entity
Organization

Contact information

Practice address
A4 CALLE VILLA MARIA, C/LEOPOLDO DIAZ #1, TOA ALTA, PR 00953-2301
(787) 870-1272
Mailing address
PO BOX 716, DORADO, PR 00646-0716
(787) 870-1272

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
5589
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7190010
JUAN C ECHEANDIA
PR
01
7580034
VICTOR M BURGOS RIVERA
PR
01
9120018
OTTO RIOS DONES
PR
01
9600020
JORGE L SANCHEZ TORRES
PR
Enumeration date
06/06/2008
Last updated
06/06/2008
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