Organization
RIO GRANDE MEDICAL GROUP
Active
Other names
SAME
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN LOPEZ M.D. (PRESIDENT)
(787) 637-4449
Entity
Organization
Contact information
Practice address
VILLAS DE RIO GRANDE, CALLE 4 L 1, RIO GRANDE, PR 00745-0000
(787) 888-7336
(787) 887-4045
Mailing address
VILLAS DE RIO GRANDE, CALLE 4 L 1, RIO GRANDE, PR 00745-0000
(787) 888-7336
(787) 887-4045
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
172590
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172590
FORMER LEGAL BUSINESS NAME
PR
Enumeration date
04/01/2010
Last updated
04/01/2010
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