Provider Demographics
NPI:1013395334
Name:INTEGRATED GROUP CARE
Entity Type:Organization
Organization Name:INTEGRATED GROUP CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-845-1188
Mailing Address - Street 1:A1 CARR 1
Mailing Address - Street 2:BO JAUCA
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-466-4771
Mailing Address - Fax:
Practice Address - Street 1:1A1 VILLA JAUCA
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-2703
Practice Address - Country:US
Practice Address - Phone:787-466-4771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085218Medicare PIN