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U3-19 Crr 21 Las Lomas San Juan PR 00921 | |
| (787) 775-0100 | |
| (787) 775-0700 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | U3-19 Crr 21 Las Lomas, San Juan, Puerto Rico |
| Authorized Official Name and Position | Martha Y Gomez Cuellar (PRESIDENTE) |
| Authorized Official Contact | 7874502757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Pmb212 Po Box 70344 San Juan PR 00936 Ph: (787) 775-0100 | U3-19 Crr 21 Las Lomas San Juan PR 00921 Ph: (787) 775-0100 |
| NPI Number | 1548978349 |
|---|---|
| Provider Enumeration Date | 11/10/2022 |
| Last Update Date | 02/03/2025 |
| Medicare PECOS PAC ID | 6800267790 |
|---|---|
| Medicare Enrollment ID | O20230201002445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548978349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Martha Y Gomez |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003822651 PECOS PAC ID: 0244138451 Enrollment ID: I20031226000133 |
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