Organization
COSTA ESTE MEDICAL SERVICES LLC
Active
Other names
COSTA ESTE MEDICAL SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ISMARY M GONZALEZ DO (PRESIDENT)
(787) 646-7769
Entity
Organization
Contact information
Practice address
AVE PRINCIPAL F4, URB BARALT, FAJARDO, PR 00738
(787) 860-3700
(787) 860-3800
Mailing address
PO BOX 1001, LUQUILLO, PR 00773-1001
(787) 860-3700
(787) 860-3800
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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