Provider Demographics
NPI:1316685399
Name:COMPREHENENSIVE GERIATRIC CARE OF SAN JUAN
Entity type:Organization
Organization Name:COMPREHENENSIVE GERIATRIC CARE OF SAN JUAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:NARVAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-918-8227
Mailing Address - Street 1:PO BOX 19237
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-1237
Mailing Address - Country:US
Mailing Address - Phone:787-918-8227
Mailing Address - Fax:
Practice Address - Street 1:1801 AVE PONCE DE LEON STE 207
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1917
Practice Address - Country:US
Practice Address - Phone:787-918-8227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management