Organization
PERFORMANCE SPORTS MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRA E GONZALEZ VEGA MD (PRESIDENT)
(787) 831-5831
Entity
Organization
Contact information
Practice address
60 CALLE RMN BTNCES N STE 207, MAYAGUEZ, PR 00680-6695
(787) 831-5831
Mailing address
PO BOX 631, CABO ROJO, PR 00623-0631
(787) 831-5831
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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