Organization
BASIC MEDICAL GROUP,INC
Active
Other names
BASIC MEDICAL GROUP,INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUZ C. CASTELLANO M.D. (PRESIDENTE)
(787) 751-8758
Entity
Organization
Contact information
Practice address
AVENIDA MUNOZ RIVERA, PARADA 31, SAN JUAN, PR 00917
(787) 751-8757
(787) 751-8757
Mailing address
AVENIDA MUNOZ RIVERA, PARADA 31, HATO REY, PR 00917
(787) 751-8757
(787) 751-8757
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5830191251
CLASSICARE
PR
01
—
7321
AMERICAN HEALTH
PR
Enumeration date
05/16/2007
Last updated
08/22/2020
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