Organization
MEDICAL DOMICILIARY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE LOPEZ (PRESIDENT)
(787) 627-0424
Entity
Organization
Contact information
Practice address
CIUDAD JARDIN DE GURABO NUMBER 168 CALLE CUNDEAMOR, GURABO, PR 00778
(787) 627-0424
Mailing address
CIUDAD JARDIN DE GURABO NUMBER 168 CALLE CUNDEAMOR, GURABO, PR 00778
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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