Provider Demographics
NPI:1942432695
Name:GRUPO DE SERVICIOS MEDICOS CDV
Entity Type:Organization
Organization Name:GRUPO DE SERVICIOS MEDICOS CDV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODRIGUEZ-SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-972-1333
Mailing Address - Street 1:PO BOX 364942
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4942
Mailing Address - Country:US
Mailing Address - Phone:787-972-1233
Mailing Address - Fax:787-946-3799
Practice Address - Street 1:115 CARR 592
Practice Address - Street 2:BO. AMUELAS
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2409
Practice Address - Country:US
Practice Address - Phone:787-972-1233
Practice Address - Fax:787-946-3799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility