Provider Demographics
NPI:1003699851
Name:C O P R MEDICAL GROUP LLC
Entity type:Organization
Organization Name:C O P R MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:F
Authorized Official - Last Name:HERNANDEZ-ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-688-1714
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-0925
Mailing Address - Country:US
Mailing Address - Phone:787-662-5968
Mailing Address - Fax:
Practice Address - Street 1:400 AVE DOMENECH STE 606
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3746
Practice Address - Country:US
Practice Address - Phone:787-688-1714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical