Provider Demographics
NPI:1922339225
Name:MEDICOS DE FAMILIA IMF, CSP
Entity Type:Organization
Organization Name:MEDICOS DE FAMILIA IMF, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:CRUZ IGARTUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-380-9558
Mailing Address - Street 1:CIUDAD JARDIN I
Mailing Address - Street 2:CALLE AZALEA #92
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4845
Mailing Address - Country:US
Mailing Address - Phone:939-246-5011
Mailing Address - Fax:787-797-8398
Practice Address - Street 1:FD ROOSEVELT #1028
Practice Address - Street 2:PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2904
Practice Address - Country:US
Practice Address - Phone:787-781-8272
Practice Address - Fax:787-783-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty