Provider Demographics
NPI:1982445243
Name:MCOM LLC
Entity type:Organization
Organization Name:MCOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:CALIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-601-3014
Mailing Address - Street 1:4735 AVE ISLA VERDE
Mailing Address - Street 2:COND VILLAS DEL MAR OESTE APT 6H
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5442
Mailing Address - Country:US
Mailing Address - Phone:787-601-3014
Mailing Address - Fax:
Practice Address - Street 1:4735 AVE ISLA VERDE
Practice Address - Street 2:COND VILLAS DEL MAR OESTE APT 6H
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5442
Practice Address - Country:US
Practice Address - Phone:787-601-3014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty