Provider Demographics
NPI:1629682125
Name:GRUPO MED
Entity Type:Organization
Organization Name:GRUPO MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:SAMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI SHEHADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-529-3102
Mailing Address - Street 1:FIRST FEDERAL BUILDING SUITE 302
Mailing Address - Street 2:1519 AVE PONCE DE LEON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-725-8101
Mailing Address - Fax:787-725-8101
Practice Address - Street 1:FIRST FEDERAL BUILDING SUITE 302
Practice Address - Street 2:1519 AVE PONCE DE LEON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-725-8101
Practice Address - Fax:787-725-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty