GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC; NPI #1316384100

Contact Information

GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC

CALLE SGTO. HERNANDEZ CARRION
MMC PROFESSIONAL PLAZA, SUITE 307
MANATI, PR 00674

Phone: 787-884-0310
Fax: 787-854-3270
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Endoscopy	261QE0800X

Indicates primary specialty

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NPI Profile & details for GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC

NPI Number 1316384100

LBN Legal business name GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC

Authorized official SAMUEL RIVERA DE JESUS - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/03/2013

Last updated 06/03/2013 - About 13 years ago

Identifiers

License #

18138

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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