Organization
INTERNATIONAL CLINITIAN MEDICAL GROUP PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO CARRAZANA (PRESIDENT)
(787) 587-5410
Entity
Organization
Contact information
Practice address
AVE HOSTO #54, SAN JUAN, PR 00919
(787) 587-5410
Mailing address
PO BOX 1198, BAYAMON, PR 00960-1198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15309
PR
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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