Organization
INTERNAL MEDICINE CANOVANAS GROUP CORP.
Active
Other names
Centro Cuidado Preventivio
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOURDES MERINO (MANAGER)
(787) 256-0848
Entity
Organization
Contact information
Practice address
48 CALLE ORQUIDEA, URB LOIZA VALLEY, CANOVANAS, PR 00729-3596
(787) 256-0848
(787) 256-2990
Mailing address
PO BOX 20000, PMB 121, CANOVANAS, PR 00729
(787) 256-0848
(787) 256-2990
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HQ871A
MEDICARE PTAN
PR
Enumeration date
02/07/2014
Last updated
02/07/2014
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