Organization
PRESTIGE MEDICAL GROUP LJCPSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORENZO E BOSQUE MD (PRESIDENT)
(787) 760-6604
Entity
Organization
Contact information
Practice address
MONTEHEIDRA TOWN CTR, GUARAGUAO 145, SAN JUAN, PR 00926-7007
(787) 760-6604
(787) 292-0130
Mailing address
MONTEHIEDRA, GUARAGUAO 145, SAN JUAN, PR 00926
(787) 760-6604
(787) 292-0130
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4863
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4863
LIC
PR
Enumeration date
12/11/2007
Last updated
04/03/2008
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