Organization
CMDA DE PUERTORICO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIETRICH K. GENTSCH (EXECUTIVE DIRECTOR)
(787) 780-2425
Entity
Organization
Contact information
Practice address
51 CALLE DR VEVE, BAYAMON, PR 00961-6362
(787) 780-1445
Mailing address
PO BOX 6181, BAYAMON, PR 00960-5181
(787) 780-1445
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2006
Last updated
05/27/2010
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