Organization
SGMJ MEDICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN BONILLA GONZALEZ MD (GENERAL PRACTICE)
(787) 378-4017
Entity
Organization
Contact information
Practice address
39 CALLE MUNOZ RIVERA, AGUAS BUENAS, PR 00703-3233
(787) 732-7424
(787) 732-7424
Mailing address
PO BOX 4952, SIUTE 343, CAGUAS, PR 00726-4952
(787) 732-7424
(787) 732-7424
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
823035
DRIVER LINCEN
PR
Enumeration date
06/11/2020
Last updated
06/11/2020
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