| Organization Name: | LA PLATA MEDICAL GROUP |
| NPI Number: | 1114186814 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICTOR M BURGOS (PRESIDENT) |
| Mailing Address: | A4 Calle Villa Maria C/leopoldo Diaz #1 Toa Alta |
| State: | PR US |
| Postal Code: | 009532301 |
| Phone Number: | 7878701272 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2008 |
| NPI Last Update Date: | 06/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 5589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |