| Cidra Montana LLC | |
|
A12 Calle Corchado, Esq Angel L Ortiz Urb Paradise Caguas PR 00726 | |
| (787) 747-0022 | |
| Not Available |
| Full Name | Cidra Montana LLC |
|---|---|
| Speciality | General Practice |
| Location | A12 Calle Corchado, Esq Angel L Ortiz, Caguas, Puerto Rico |
| Authorized Official Name and Position | Diego D Vargas Gonzalez (PRESIDENT) |
| Authorized Official Contact | 7877470022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cidra Montana LLC Po Box 2010 Caguas PR 00726-2010 Ph: (787) 747-0022 | Cidra Montana LLC A12 Calle Corchado, Esq Angel L Ortiz Urb Paradise Caguas PR 00726 Ph: (787) 747-0022 |
| NPI Number | 1700624285 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 07/19/2024 |
| Certification Date | 07/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700624285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Secondary |
| 208000000X | Pediatrics | () | Secondary |
| 208D00000X | General Practice | () | Primary |
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