Provider Demographics
NPI:1033810767
Name:CARIBBEAN MEDICAL MANAGEMENT GROUP
Entity type:Organization
Organization Name:CARIBBEAN MEDICAL MANAGEMENT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-274-9637
Mailing Address - Street 1:CALLE VERDOLAGA A89 CIUDAD JARDIN
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-615-5575
Mailing Address - Fax:
Practice Address - Street 1:CARR 185 KM 0.6 LOTE SONA INDUSTRIAL COMERCIAL
Practice Address - Street 2:LOCAL #1
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-615-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty