Provider Demographics
NPI:1073034591
Name:LOGIC EMERGENCY GROUP PSC
Entity Type:Organization
Organization Name:LOGIC EMERGENCY GROUP PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-365-1878
Mailing Address - Street 1:216 MANSIONES DEL GOLF
Mailing Address - Street 2:CAGUAS REAL
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-365-1878
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 11.7
Practice Address - Street 2:HOSPITAL HERMANOS MELENDEZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-365-1878
Practice Address - Fax:787-365-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16571208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty