NPI 1043595291

MD Renal Group LLC

Organisation Exclusive Provider Organization Aguadilla, PR

Practice location

Address: Avenue Severiano Cuevas 18 Hospital Buen Samaritano Ground Floor, Aguadilla, PR 00605-9026
Phone: (787) 997-0101
Mailing address: PO Box 667, Moca, PR 00676-0667

Authorised official

Name: Mayra I Santiago
Title: Administrative Chief Officer
Phone: (939) 639-0557

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 17129 (PR)

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Registry record

NPI: 1043595291
Entity type: Organization
NPI issued: 19 Oct 2011
Record last updated: 14 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.