Provider Demographics
NPI:1679994024
Name:HG MEDICAL SERVICES PSC
Entity Type:Organization
Organization Name:HG MEDICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MD
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-767-7885
Mailing Address - Street 1:PO BOX 1969
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1967
Mailing Address - Country:US
Mailing Address - Phone:787-767-7885
Mailing Address - Fax:787-767-5626
Practice Address - Street 1:TORRE MEDICA AUXILIO MUTUO
Practice Address - Street 2:SUITE 413
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-767-7885
Practice Address - Fax:787-767-5626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9042207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE66545Medicare UPIN