Organization
CIDRA MONTANA LLC
Active
Other names
CIDRA MONTANA LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DIEGO D VARGAS GONZALEZ (PRESIDENT)
(787) 747-0022
Entity
Organization
Contact information
Practice address
A12 CALLE CORCHADO, ESQ ANGEL L ORTIZ, URB PARADISE, CAGUAS, PR 00726
(787) 747-0022
Mailing address
PO BOX 2010, CAGUAS, PR 00726-2010
(787) 747-0022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/19/2024
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