| NPI | 1700624285 |
|---|---|
| Former Legal Business Name | CIDRA MONTANA LLC |
| Entity Type | Organization |
| Authorized Contact | DIEGO D VARGAS GONZALEZ President 787-747-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2024-07-19 |