Provider Demographics
NPI:1487998787
Name:CARIBBEAN INFECTOLOGY CONSULTING GROUP, L.L.C.
Entity type:Organization
Organization Name:CARIBBEAN INFECTOLOGY CONSULTING GROUP, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:JORGE
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-315-7917
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0712
Mailing Address - Country:US
Mailing Address - Phone:787-315-7917
Mailing Address - Fax:
Practice Address - Street 1:2053 PONCE BY PASS SUITE 205
Practice Address - Street 2:EDIFICIO CENTRO CARIBE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1308
Practice Address - Country:US
Practice Address - Phone:787-315-7917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QI0500X
PR10613207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Single Specialty