Basic Information
| Provider Information | |||||||||
| NPI: | 1124350574 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MORGAR CSP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11665 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876411616 | ||||||||
| FaxNumber: | 7877276224 | ||||||||
| Practice Location | |||||||||
| Address1: | ROBERTO CLEMENTE AVE STREET 76 | ||||||||
| Address2: | 114 #4 | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876411616 | ||||||||
| FaxNumber: | 7877276224 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2010 | ||||||||
| LastUpdateDate: | 02/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | GARCIA | ||||||||
| AuthorizedOfficialFirstName: | LOURDES | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7876411616 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207U00000X | 11116 | PR | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Nuclear Medicine | 207RC0000X | 10647 | PR | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.