Organization
BASIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ C CASTELLANO (PRESIDENT)
(787) 273-1227
Entity
Organization
Contact information
Practice address
402 AVE MUNOZ RIVERA, SAN JUAN, PR 00918-3310
(787) 754-8612
Mailing address
PO BOX 191060, SAN JUAN, PR 00919-1060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6366
PR
Other
Enumeration date
05/19/2006
Last updated
08/22/2020
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