Provider Demographics
NPI:1073797817
Name:GRUPO MEDICO NEW CARE
Entity Type:Organization
Organization Name:GRUPO MEDICO NEW CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATE OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:787-614-9285
Mailing Address - Street 1:525 PARQ CENTRAL
Mailing Address - Street 2:CALLE S CUEVAS BUSTAMANTE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2642
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 PARQ CENTRAL
Practice Address - Street 2:CALLE S CUEVAS BUSTAMANTE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2642
Practice Address - Country:US
Practice Address - Phone:787-614-9285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR207RC0000X, 208D00000X
PR15268208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty