Organization
GRUPO GERIATRICO DE MEDICINA DE FAMILIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS M. GUTIERREZ (PRESIDENT)
(787) 787-9694
Entity
Organization
Contact information
Practice address
IJ-3 CALLE PALMA REAL P2, URB ROYAL PALM, BAYAMON, PR 00959
(787) 787-9694
(787) 787-9701
Mailing address
IJ-3 CALLE PALMA REAL P2, URB ROYAL PALM, BAYAMON, PR 00959
(787) 787-9694
(787) 787-9701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7119
PR
174400000X
Specialist
8723
PR
174400000X
Specialist
9865
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100293
LA CRUZ AZUL DE PR
PR
01
—
3120
PREFERRED MEDICAL CHOICE
PR
01
—
890448
MMM HEALTHCARE
PR
Enumeration date
07/01/2005
Last updated
08/22/2020
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