Agm-Ge,LLC
Organization Active NPI Gastroenterology Physician · Manati, PR
NPI 1144568098 · NPPES record last updated Jan 28, 2013
Key facts
- NPI
- 1144568098
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 13604 (PR)
- Legal business name
- AGM-GE,LLC
- Practice address
- J23 Calle Elliot Velez
Urb Atenas
Manati, PR 00674-4616 - Phone
- (787) 854-0404
- Fax
- (787) 854-0403
- NPI assigned
- Jan 28, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Aileen Guzman, M.D.
- Title
- Administrator
- Phone
- (787) 449-2201
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131009001353 | PR | Part B Supplier - Clinic/Group Practice | 7113151952 |
Receives reassigned benefits from 1 practitioner Practice locations: Manati, PR |
National Provider Directory
Locations
J23 Calle Elliot Velez
Ste 201
Manati, PR 00674
Phone (787) 854-0404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | 13604 | PR | Yes |
Addresses
Primary practice location
J23 Calle Elliot Velez
Urb Atenas
Manati, PR 00674-4616
Mailing address
33 Calle Amber
Treasure Point
Vega Alta, PR 00692-8917
Phone (787) 449-2201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13604 | Other | PR | LICENSE |
| 0021143 | Other | PR | MEDICARE |
| 207RG0100X | Other | PR | TAXONOMY |
Other providers in Manati, PR
- Luis Fernando Adorno Burgos
- Angel A Adorno
- Jose Miguel Adornofebo
- Adriana Marzan Loyola LLC
- Advance Rehabilitation Center Inc
- Andrea Agosto
- Lymarie I Aguila Gonzalez
- Kevin Aguila Guzman
- Ajc Surgical Health PSC
- Luma Al-Attar
All providers in Manati, PR · Gastroenterology Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.