Organization
MDM GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN NIEVES (PRESIDENT)
(787) 721-0274
Entity
Organization
Contact information
Practice address
1225 AVE PONCE DE LEON, VIG TOWER SUITE 801, SANTURCE, PR 00907-3907
(787) 721-0274
(787) 757-8969
Mailing address
PO BOX 19718, SAN JUAN, PR 00910-1718
(787) 721-0274
(787) 757-8969
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1386714251
PR
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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