Organization
GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL RIVERA DE JESUS M.D. (OWNER)
(787) 646-9724
Entity
Organization
Contact information
Practice address
CALLE SGTO. HERNANDEZ CARRION, MMC PROFESSIONAL PLAZA, SUITE 307, MANATI, PR 00674
(787) 884-0310
(787) 854-3270
Mailing address
1353 AVE LUIS VIGOREAUX, PMB 389, GUAYNABO, PR 00966-2715
(787) 884-0310
(787) 854-3270
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
18138
PR
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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