| Elite Medical Group Llc | |
|
Western Medical Plaza Suite 6 Aguadilla PR 00603 | |
| (393) 339-2976 | |
| Not Available |
| Full Name | Elite Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | Western Medical Plaza, Aguadilla, Puerto Rico |
| Authorized Official Name and Position | Michael Rodriguez Tirado (DIRECTOR) |
| Authorized Official Contact | 3933392976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Medical Group Llc Urb. Villas De Las Praderas Calle Las Gaviotas, Casa #54 Rincon PR 00677 Ph: (939) 339-2976 | Elite Medical Group Llc Western Medical Plaza Suite 6 Aguadilla PR 00603 Ph: (393) 339-2976 |
| NPI Number | 1023885878 |
|---|---|
| Provider Enumeration Date | 12/11/2023 |
| Last Update Date | 12/11/2023 |
| Medicare PECOS PAC ID | 6608228697 |
|---|---|
| Medicare Enrollment ID | O20240116000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023885878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Michael A Rodriguez Tirado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932831591 PECOS PAC ID: 7416309406 Enrollment ID: I20240116000040 |
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