Organization
ANGELORUM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS M GONZALEZ BERMUDEZMD MD (PRESIDENT)
(787) 270-4747
Entity
Organization
Contact information
Practice address
CARR 693 KM 13.8 SUITE 171 BO BRENAS, VEGA ALTA, PR 00692
(787) 270-4747
(787) 270-4747
Mailing address
PO BOX 356, VEGA ALTA, PR 00692-0356
(787) 270-4747
(787) 270-4747
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
57474
PR
261QR0200X
Radiology Clinic/Center
57474
PR
291U00000X
Clinical Medical Laboratory
57474
PR
Other
Enumeration date
05/06/2010
Last updated
05/06/2010
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