Provider Demographics
NPI:1881818003
Name:GRUPO MEDICO FAMILIAR
Entity Type:Organization
Organization Name:GRUPO MEDICO FAMILIAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-449-8806
Mailing Address - Street 1:HC 5 BOX 93480
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9568
Mailing Address - Country:US
Mailing Address - Phone:787-449-8806
Mailing Address - Fax:
Practice Address - Street 1:HC 5 BOX 93480
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9568
Practice Address - Country:US
Practice Address - Phone:787-449-8806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRJ03125OtherSSS
PR994269OtherMEDICARE Y MUCHO MAS
PR22333Medicare ID - Type Unspecified