Provider Demographics
NPI:1134826506
Name:GRUPO GERIATRICO DEL NORTE PFC
Entity type:Organization
Organization Name:GRUPO GERIATRICO DEL NORTE PFC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-854-0671
Mailing Address - Street 1:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-354-5670
Mailing Address - Fax:
Practice Address - Street 1:GRUPO GERIATRICO DEL NORTE
Practice Address - Street 2:Q1 COND VILLAS DE LA PLAYA 1, C CONDONINIO GERIATRICO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-854-0671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty