Provider Demographics
NPI:1588970131
Name:GRUPO MEDICO SUR-MED
Entity type:Organization
Organization Name:GRUPO MEDICO SUR-MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:REYES VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, JD
Authorized Official - Phone:787-824-1100
Mailing Address - Street 1:PO BOX 1162
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-1162
Mailing Address - Country:US
Mailing Address - Phone:787-824-1100
Mailing Address - Fax:787-824-7655
Practice Address - Street 1:8 CALLE COLON PACHECO
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-3344
Practice Address - Country:US
Practice Address - Phone:787-824-1100
Practice Address - Fax:787-824-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty