Provider Demographics
NPI:1023717980
Name:THE GOOD DOCTOR, LLC
Entity type:Organization
Organization Name:THE GOOD DOCTOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:BBA, BFA
Authorized Official - Phone:787-460-3640
Mailing Address - Street 1:ELMA 548
Mailing Address - Street 2:CAPARRA HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-460-3640
Mailing Address - Fax:
Practice Address - Street 1:A3 AVE. PEREZ ANDINO
Practice Address - Street 2:VILLAS DE RIOGRANDE
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-888-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service