Organization
GRUPO MEDICO DEL NORTE INC.
Active
Other names
MIRAMAR MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN CEREZO M.D. (PRESIDENT)
(787) 721-5696
Entity
Organization
Contact information
Practice address
804 AVE PONCE DE LEON, SUITE 101A, SAN JUAN, PR 00907-3301
(787) 721-5696
Mailing address
804 AVE PONCE DE LEON, SUITE 101A, SAN JUAN, PR 00907-3301
(787) 721-5696
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
352173
PR
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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