Organization
EASTERN ADVANCED MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN RODRIGUEZ (ADMINSITRATOR)
(787) 285-0655
Entity
Organization
Contact information
Practice address
CALLE DUFRESNE NO. 59 W, HUMACAO, PR 00791-3609
(787) 285-0655
Mailing address
CALLE DUFRESNE NO. 59 W, HUMACAO, PR 00791-3609
(787) 285-0655
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
PR
Other
Enumeration date
06/13/2006
Last updated
08/22/2020
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