LDG Medical Services Group, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LDG MEDICAL SERVICES GROUP, LLC

Practice address

1225 Ponce de Leon
Vig Tower Suite 702
San Juan, PR 00907-1903

Phone

(787) 721-0279

Fax

(877) 777-3208

NPI assigned

Mar 6, 2018

Last updated

Oct 5, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William De Gracia

Title

Treasurer

Phone

(787) 479-6620

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1740782788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 PONCE DE LEON AVE",
            "address_2": "VIG TOWER SUITE 702",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073108",
            "telephone_number": "787-479-6620",
            "fax_number": "877-777-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 PONCE DE LEON",
            "address_2": "VIG TOWER SUITE 702",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071903",
            "telephone_number": "787-721-0279",
            "fax_number": "877-777-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDG MEDICAL SERVICES GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "DE GRACIA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "787-479-6620"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.