Provider Demographics
NPI:1720480528
Name:CARIBBEAN MEDICAL GROUP INC.
Entity type:Organization
Organization Name:CARIBBEAN MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:787-796-0505
Mailing Address - Street 1:425 CARR 693 STE 350
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4816
Mailing Address - Country:US
Mailing Address - Phone:787-796-0505
Mailing Address - Fax:787-957-8808
Practice Address - Street 1:410 CALLE MENDEZ VIGO
Practice Address - Street 2:SUITE 203
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4800
Practice Address - Country:US
Practice Address - Phone:787-796-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR339076291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory