Provider Demographics
NPI:1841806742
Name:NEX-GEN MEDICAL SERVICES P S C
Entity Type:Organization
Organization Name:NEX-GEN MEDICAL SERVICES P S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MODESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-360-0610
Mailing Address - Street 1:VILLAS UNIVERSITARIAS UPR 64
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-360-0610
Mailing Address - Fax:
Practice Address - Street 1:CARR 107 KM 2.9 BO. BORINQUEN
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-0060
Practice Address - Country:US
Practice Address - Phone:787-891-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty