Provider Demographics
NPI:1750538468
Name:GRUPO RESCUE
Entity type:Organization
Organization Name:GRUPO RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-931-1717
Mailing Address - Street 1:3508 NORTH WEST 114 AVE
Mailing Address - Street 2:BM30095
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178
Mailing Address - Country:US
Mailing Address - Phone:407-931-1717
Mailing Address - Fax:407-931-2121
Practice Address - Street 1:CARRETERRA BAVARO, EDIF. CENTRO MEDICO PUNTA CANA
Practice Address - Street 2:
Practice Address - City:BAVARO,
Practice Address - State:LA ALTAGRACIA
Practice Address - Zip Code:DOM REPUBLIC
Practice Address - Country:DO
Practice Address - Phone:407-931-1717
Practice Address - Fax:407-931-2121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO MEDICO PUNTA CANA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care