| Brg Medical Llc | |
|
400 Ave Domenech Ste 607 San Juan PR 00918-3746 | |
| (787) 250-0084 | |
| (787) 946-1481 |
| Full Name | Brg Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 Ave Domenech Ste 607, San Juan, Puerto Rico |
| Authorized Official Name and Position | Waldemar Charles Rios (PRESIDENT) |
| Authorized Official Contact | 7872494614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brg Medical Llc 400 Ave Domenech Ste 607 San Juan PR 00918-3746 Ph: (787) 250-0084 | Brg Medical Llc 400 Ave Domenech Ste 607 San Juan PR 00918-3746 Ph: (787) 250-0084 |
| NPI Number | 1033580840 |
|---|---|
| Provider Enumeration Date | 10/20/2015 |
| Last Update Date | 10/20/2015 |
| Medicare PECOS PAC ID | 6103128459 |
|---|---|
| Medicare Enrollment ID | O20160105000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033580840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 14760 (Puerto Rico) | Primary |
| Provider Name | Waldemar Rios |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003884065 PECOS PAC ID: 8224085113 Enrollment ID: I20050404000098 |
| Provider Name | Carlos R Benitez Colon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437195005 PECOS PAC ID: 1658474390 Enrollment ID: I20070316000409 |
| Provider Name | Benjamin Guardiola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265593370 PECOS PAC ID: 1456445808 Enrollment ID: I20070917000466 |
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