Provider Demographics
NPI:1205044013
Name:TIGER MED CORP
Entity Type:Organization
Organization Name:TIGER MED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-286-2800
Mailing Address - Street 1:PO BOX 1357
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1357
Mailing Address - Country:US
Mailing Address - Phone:787-286-2800
Mailing Address - Fax:787-745-0108
Practice Address - Street 1:3 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-2602
Practice Address - Country:US
Practice Address - Phone:787-286-2800
Practice Address - Fax:787-745-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization